SIRCDIS301 - Accept Prescriptions and return dispensed ...€¦ · SIRCDIS301 Accept prescriptions and return dispensed medicines to customers NATV3 230316 Page 4 of 78 INTRODUCTION

SIRCDIS301 - Accept Prescriptions and return

dispensed medicines to customers

Name:

Pharmacy Name:

SIRCDIS301 Accept prescriptions and return dispensed medicines to customers

NATV3 230316 Page 2 of 78

Disclaimer

The content of this Learner Guide is based on competency standards from the Retail Services

Training Package SIR07. However, nothing in the content should be taken as conflicting with, or

contradicting, standards of pharmacy practice or pharmacy operations as may be laid down from

time to time by the Pharmacy Board of Australia, or pharmacy operations and policy laid down by

the proprietor.

Before using this Learner Guide as a training resource for the pharmacy assistant, it is

recommended that proprietors review the contents to ensure that it does not contain any such

conflicts or contradictions.

In case of any doubt or uncertainty, the pharmacy assistant should refer the matter directly to the

pharmacist.

© The Pharmacy Guild of Australia

Copyright for all materials relating to the National Training Course for Pharmacy Assistants is held

by The Pharmacy Guild of Australia. Please ensure that materials are not copied or used for any

other purpose other than training with Guild Training Services.

For advice relating to information contained in this document or other Guild Training documents

please contact:

Head, Guild Pharmacy Academy

The Pharmacy Guild of Australia

National Secretariat

PO Box 310

FYSHWICK ACT 2610

Telephone (02) 6270 1888



Table of contents

Introduction…………………………………………………………………………………………………… 4

Accept prescriptions and return dispensed medicines to customers………………………………….. 7

Understanding prescriptions ........................................................................................................... 7

Confidentiality, privacy and trust ..................................................................................................... 8

Medicines and poisons scheduling ................................................................................................ 10

The prescription ............................................................................................................................ 14

Examples of prescriptions ............................................................................................................. 15

Legal and professional requirements of a valid prescription .......................................................... 18

Subsidising the cost of prescription medicines .............................................................................. 20

The Pharmaceutical Benefits Scheme (PBS) ................................................................................ 21

Repatriation Pharmaceutical Benefits Scheme ............................................................................. 28

Private prescriptions ..................................................................................................................... 29

Accepting prescriptions ................................................................................................................. 29

Areas of the pharmacy where prescriptions are prepared ............................................................. 30

The process of dispensing a prescription and the role of the pharmacy assistant ......................... 31

Checking details when accepting a prescription ............................................................................ 33

A recommended approach for obtaining and checking prescription details ................................... 34

The process of accepting a prescription in more detail .................................................................. 35

Reviewing the steps of accepting prescription ............................................................................... 56

What if something is not right? ...................................................................................................... 57

Passing the prescription and relevant information to the pharmacist ............................................. 58

Be aware of your customers ......................................................................................................... 60

When things get busy ................................................................................................................... 61

Prescriptions by telephone ............................................................................................................ 61

Prescriptions held on file at the pharmacy ..................................................................................... 62

Returning dispensed medicines to customers ............................................................................... 64

“Your prescription is ready” ........................................................................................................... 64

The process of returning dispensed medicines to a customer ....................................................... 65

Relaying information to the customer ............................................................................................ 72

Ensuring that your customer has everything they need ................................................................. 76

Packing dispensed medicines ....................................................................................................... 78

Conclusion .................................................................................................................................... 78



INTRODUCTION

Welcome. This program is designed to give you skills and knowledge required for a rewarding

career in community pharmacy. This is the Learner Guide for the unit SIRCDIS301 Accept

prescriptions and return dispensed medicines to customers.

This unit is one of the core units from the Community Pharmacy Training Package. This training

sits within the Retail Services Training Package and offers qualifications at Certificate II, III and IV

in Community Pharmacy. Please take time to read the Learner Handbook. It contains important

information that will assist you with your training.

On completion of this unit you will be able to:

Approach the customer and accept prescription in a timely manner

Check customer’s prescriptions for legality, validity and completeness and confirm customer

details

Respect customer privacy and confidentiality when requesting and providing information.

Identify and confirm items to be dispensed.

Provide brand substitution information to the customer and determine customer preference.

Flag and refer prescription discrepancies and other situations requiring additional assistance

to appropriate pharmacy staff or a pharmacist.

Advise customers of expected prescription preparation time, including delaying factors or

delivery times as appropriate.

Lodge verified prescriptions together with relevant recorded customer information for

dispensing

Verify that dispensed prescriptions have been checked by a pharmacist and check dispensed

medicines to ensure customer’s requested items and quantities have been dispensed.

Verify that the customer receives the correct medicine and that the customer or their agent

signs and dates the prescription as confirmation of receipt.

Explain information provided on medicines and question to confirm customer understanding.

Refer customers to a pharmacist in situations requiring additional assistance or therapeutic

advice.

Supply dispensed medicines promptly in appropriate packaging

Provide information on other products where required to effectively use medicines supplied.

Retain completed prescriptions in a nominated secure area.



In order to achieve competency in this unit you must demonstrate the ability to:

Accept and lodge prescriptions for dispensing

Identify different types of prescriptions and entitlements

Follow verification procedures when providing dispensed medicines to customers

Operate as part of a dispensing team and provide relevant information to a pharmacist and

other pharmacy staff as required

Provide prescription information to customers in ways appropriate to customer needs and

demonstrate appropriate techniques to confirm understanding

Recognise and act on situations requiring referral to a pharmacist or other pharmacy staff.

Further information regarding this unit of competency can be found at www.training.gov.au

How to complete your training and assessment

Step 1 - Read through the learner guide and complete the activities included. These activities

assist you to understand how your pharmacy operates and provides you with the skills and

knowledge to be an effective member of your pharmacy team.

Step 2 - Complete the Assessment Section at the back of the learner guide. The Assessment

Section is made up of a number of different sections:

Knowledge check – you will need to complete all question within this section. Please provide

answers that are clear and detailed.

Portfolio – these assessment activities require you to gather evidence of what you do in the

pharmacy, undertake research or complete workplace tasks. You may need to attach additional

documents, photographs or evidence to this section

Practical Activities – your Guild trainer/assessor will ask you a series of questions or undertake a

role play with you. This may be done in the pharmacy or over the telephone. You can read the

questions or role plays and prepare for this assessment.

Step 3 - Supervisors Evidence Report – work with your workplace supervisor to complete this

document. Your workplace supervisor needs to observe you completing a range of tasks and

activities. Read through the Supervisor Evidence Report and discuss with your workplace

supervisor the skills that you will need to demonstrate. Talk about times when this observation

should occur.

Step 4 - Assessment Cover Sheet – you and your workplace supervisor will need to complete and

sign this document. Don’t forget to include the date that you commenced work on this unit and the

date that you completed it. The checklist can be used to check that you have completed all

sections of the required assessment.

For further information on this unit, how to complete it and the assessment section please refer to

the learner handbook that you were provided during your induction or you can access this

document at www.guildtraining.com.au



Pharmacy policies and procedures

One of the most frequent reasons for a customer to visit a

pharmacy is to have a prescription dispensed. Pharmacy’s policies

and procedures help to ensure the pharmacy delivers a consistent,

high-quality service to customers. This gives your customers a

reason to choose your pharmacy and return to you time and time

again when they need medicines and health advice.

Access your pharmacy’s policies and procedures and read and review the following documents:

Confidentiality Policy (QCPP - P1A)

Dispensing (QCPP - P2A)

Dealing with Customers (QCPP - P11C)

Brand Substitution Policy (QCPP - P2B)

Customer Service Policy (QCPP - P11B)

Dealing with Customers (QCPP - P11C)

Refer to these documents regularly as you work through this learner guide.



ACCEPT PRESCRIPTIONS AND RETURN DISPENSED

MEDICINES TO CUSTOMERS

Understanding prescriptions

In this section you will learn about:

Confidentiality, privacy and trust

Medicines and poison schedules

Who can write prescriptions

Features of prescriptions

The supply of prescription medicines is one of the most important roles that a community

pharmacy provides to its customers. For many customers, the supply of prescription medicines is

the main reason that they visit the pharmacy. Your role in the process of supplying prescription

medicines is important and vital, and one that carries a major responsibility.

Pharmacy assistants are the first point of contact for the customer when they arrive in the

pharmacy. You are the person who is responsible for speaking to the customer and identifying his

or her needs. You are the person who is responsible for communicating the customers’ needs to

the pharmacist. And you are the person responsible for checking the progress of the prescription

and informing the customer of waiting times.

If one part or one step of this process is not carried out well the customer may receive the wrong

medicine, may be charged an incorrect price, or may receive medicines that they did not want.

To ensure that the pharmacist receives complete and correct information, and the customer

receives the correct medicine, you will need to understand some of the regulations, rules and

policies set by the Commonwealth and State or Territory Governments and the Pharmacy Board of

Australia, as well as your own pharmacy’s policies. In addition to following these rules and

guidelines, you will need to ensure that your customers receive professional and caring service.

There are a number of routine steps that must be followed every time you accept a prescription

from a customer and these may take time to learn and understand. Learning the rules and policies

that apply to accepting prescriptions may seem confusing at first, but working through this unit,

watching other pharmacy assistants and working with your workplace supervisor will help you

understand the process you need to follow.

In time, the process of accepting a prescription from a customer will become familiar and you will

ensure that the information is passed from the customer to the pharmacist with ease. However, it is

important that this process is never treated lightly and that you do not become casual in your

approach. You should be constantly aware of the steps involved and ensure that the information

you provide your pharmacist and your customer is accurate and clear.



Confidentiality, privacy and trust

Information about a person’s health, medical condition and medical treatment is regarded as one of

the most sensitive types of personal information. Before discussing prescriptions and procedures

for accepting prescriptions and returning dispensed medicines to customers, the unit will review

your obligations for maintaining customer privacy.

As with all interactions with our customers, we must ensure that the information we receive, relay

or pass on remains private. All of the information that is communicated during the process of

accepting a prescription and supplying a customer with medicine is private and should remain

confidential. This is a requirement of the Commonwealth Privacy Act, as well being a professional

and ethical expectation.

The information that a customer provides us during this process is very personal. This information

can include:

Medical conditions, symptoms, treatments,

Family relationships and personal details such as where they live or work.

Customers should be able to provide us with this information and be confident that this information

will be treated with great care.

At no time should others be able to hear these conversations or the information

that is being communicated. When speaking to the customer, you should make

sure that conversations remain private and cannot be overheard by others. If

necessary, speak to the customer in a quiet part of the pharmacy or in the

counselling room or area.

When speaking to your pharmacist, the information that passes between you must also remain

private and confidential. Do not call out or ask a question of your pharmacist who may be working

in the dispensary. When you need to speak to your pharmacist, and pass on information, move into

the dispensary area and speak in a quiet manner.

The information contained on a customer's prescription can also be very personal. This information

relates to a customer's health condition and the medicines they take. The prescription also

includes their home address and other personal details. Prescriptions should be handled in a

manner that ensures that others cannot see and do not have access to this information.

For a reminder of your privacy and confidentiality requirements read your pharmacy’s

Confidentiality Policy (QCPP document P1A).



All pharmacies must comply with the Privacy Act and Australian Privacy Principles.

These are things you must NOT do:

Don't automatically provide details of a person's medication or medication

history to family members who might request this information. There are a

range of issues that you must first consider before disclosing this

information.

Don't collect information in relation to the supply of non-prescription

medications solely relying on professional guidelines. Those guidelines

may not be legally binding. Therefore, you should get the individual's

consent.

Don't provide personal details of customers or individuals to direct

marketing companies without the person's consent.

Don't provide patient details to pharmaceutical companies so that they may

send the person a reminder for prescriptions without the consent from the

customer.

Don't telephone a patient and customer and leave a message that an

identified type of medication is ready for collection.

Don't disclose information for a purpose which is not directly related to the

reason for which it was originally collected and where you are relying on

professional guidelines or codes of ethics which say that the disclosure is in

the person's best interest. These guidelines may not be legally binding and

therefore, you will probably need the person's consent.

Don't leave personal information or prescription medications ready for

collection on a public counter or in places where it can be easily accessed

or seen by unauthorised persons.

Don't comment publicly and in the presence of other customers, for

example, on dosages or the types of medications of your customer.

Don't send people a reminder for repeat prescriptions from the pharmacy

unless the patient has given their consent for this.


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Security of documentation

Prescriptions are important documents and need to be treated in a secure and private manner. The

information on a prescription is important to a number of people.

Customers’ private details and medical information is included on prescriptions and should be

treated with great care. Prescriptions should not be left lying on counters or placed in areas

where other customers have access or can read the details.

The prescription gives the pharmacist all of the information he/she requires to supply the right

medicine to the right customer. If the prescription is lost or misplaced the pharmacist is unable

to supply the medicine and the customer may have to return to their doctor. Care should be

used when accepting prescriptions and passing them onto the pharmacist. This task should be

given your full attention and you should not try to complete other tasks at the same time.

The information on prescriptions is used by the pharmacy to claim payment from the

government. Therefore the prescription must be accepted, stored and filed with great care to

make sure that it is not lost before or after dispensing.

The prescription is a very important document and is used to communicate information from

the doctor to the pharmacist. It is also used to communicate information from the pharmacist to

the customer. And finally it is used to communicate information from the pharmacist to the

government.

Great care should be taken with prescriptions to make sure they remain safe and secure whilst in

the pharmacy.

Read your pharmacy’s policies and procedures.

What steps does your pharmacy take before, during and after dispensing to make

sure that the prescription remains safe and private?

List these steps below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Medicines and poisons scheduling

When working in a pharmacy and dealing with prescriptions, it is important that you have an

understanding of the types of medicines that we provide to our customers. Your understanding of

these different medicines and the different groups to which they belong, will help you understand

many of the procedures, rules and regulations that are in place in your pharmacy.

Medicines and poisons in Australia are classified into groups known as schedules. These

schedules are decided by the Therapeutic Goods Administration which publishes the list of

medicines and poisons in the Poisons Standard (also known as the Standard for the Uniform

Scheduling of Medicines and Poisons).


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Each schedule of medicines has specific rules which describe how: substances must be packaged,

labelled and stored; businesses that are permitted to sell the products and special requirements

which control access to these products. For example, products in Schedule 4 and Schedule 8 are

only able to be supplied if a customer has a prescription.

The way that medicines and poisons are allocated into each schedule depends on a range of

factors, including:

Quantity

Safety

Toxicity

Potential for abuse

Access

Drug interactions

The following table lists Australia’s medicine and poison schedules and some characteristics and

rules that apply to each schedule. Note, the rules that apply to storage and access can differ

slightly from state to state.

In the following table, medicine schedules that must have prescriptions have a

shaded background

Name of

Schedule

Where can they be sold? Where do they need to be

stored?

(or other rules)

Comments and examples

Available for

general sale

(unscheduled)

Openly available, e.g. in

supermarkets, corner

stores as well as

pharmacies.

Can be located anywhere

in the pharmacy.

Ural sachets

Metamucil powder

Herbal products

Pharmacy

Medicines

(Schedule 2)

Only in pharmacies.

* In some states, where a

pharmacy service is not

available they may be

available from other retail

outlets which hold a licence.

Must be located in the

pharmacy’s Professional

Service Area.

May be behind the counter.

Sale by trained pharmacy

assistant

Sudafed PE® tablets

Otrivin® nasal spray

Imodium® capsules

Pharmacist Only

Medicines

(Schedule 3)

Only in pharmacies.

A pharmacist must be

directly involved in the sale

of the medicine.

Located in the Professional

Service Area in a location

where customers cannot

self-select the product.

May be stored in the

dispensary.

Hydrocortisone cream

Ventolin® inhaler

Sudafed® original

Mersyndol® tablets


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Name of

Schedule

Where can they be sold? Where do they need to be

stored?

(or other rules)

Comments and examples

Prescription

Medicines

(Schedule 4)

Supplied by pharmacies.

Customer must have a

valid prescription.

Stored in the dispensary

under direct supervision of

a pharmacist.

Dispensed by a

pharmacist. Pharmacy may

use a dispensary assistant.

Medicines to treat:

Infection

High blood pressure

High cholesterol

Many other conditions

Hazardous

substances

(Schedule 5)

Various locations, e.g.

hardware stores, garden

suppliers, supermarkets as

well as pharmacies.

Labelled with the word

CAUTION. Must be in

appropriate packaging, with

warnings and safety

directions.

These are typically

household and garden

chemicals with a low

potential for causing harm.

Methylated spirits

Hydrogen peroxide

Hazardous

poisons

(Schedule 6)

Various locations, e.g.

hardware stores, garden

suppliers.

Labelled with the word

POISON. Often in

distinctive packaging with

strong warnings and safety

directions.

Often stored out of reach of

children. Some states may

require purchaser to be

aged over 16 years.

Substances with a

moderate potential for

causing harm.

Pool chlorine

Paint thinners,

Pesticides

Dangerous

Poisons

(Schedule 7)

Licensed dealer, e.g.

agricultural specialist

stores, industrial suppliers.

Regulations restricting their

availability, possession,

storage or use may apply.

Sales must be recorded

including name, address,

quantity, purpose and

signature of buyer.

Substances with a high

potential for causing harm.

Industrial poisons

Agricultural poisons

Cyanide

Strychnine

Controlled

Drugs

(Schedule 8)

Pharmacies

Customers must have a

valid prescription.

Special rules apply to the

way prescriptions must be

written.

In a locked safe in the

dispensary. Keys must be

under control of the

pharmacist at all times.

All movements of

medicines in and out of the

pharmacy must be

recorded in a register.

OxyContin tablets

Norspan patches

Prohibited

Substances

Schedule 9

Illegal to manufacture,

possess, sell or use unless

special approval has been

given, e.g. for research or

training purposes.

Only available with

approval of Commonwealth

or State or Territory

authorities.

Must not be referenced in

any advertisement.

Cannabis

Cocaine


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Note:

Rules and regulations that apply to the each medicine schedule may be slightly

different within each state or territory of Australia.

Speak to your pharmacist or workplace supervisor

Are there any other important regulations or requirements that apply to the

storage or sale of medicines in your pharmacy?

If there are any other requirements list these below

The following information is relevant to medicines that need prescriptions.

Prescription Medicines

Schedule 4

Schedule 4 medicines are known as Prescription Medicines

and can only be supplied if the customer presents a legal

and valid prescription. Prescription Medicines are located in

the dispensary and customers do not have access to these

items.

The pharmacy assistant’s role is to ensure accurate

collection of the customer details for dispensing by the

pharmacist.

Controlled Drugs

Schedule 8

Schedule 8 items are known as Controlled Drugs. They may

also be referred to as Dangerous Medicines, Dangerous

Drugs or Drugs of Addiction. Controlled Drugs are addictive

in nature and the pharmacist must tightly control their

storage and supply.

These medicines can only be supplied to a customer who

presents a legal and valid prescription. Schedule 8 items

are tightly controlled and must be kept in a locked safe at all

times. The keys must be held on the pharmacist at all times.

Dispensed medicines and replacement stock from the

wholesaler is recorded in the Controlled Drugs register.

Occasionally you may see prescriptions for Pharmacy Medicines or Pharmacist Only Medicines.

Check with your pharmacist or workplace supervisor for the policy on how these are managed in

your pharmacy.


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The prescription

Prescription Only Medicines must be prescribed (ordered) by professionals such as doctors,

dentists, veterinary surgeons and other health professionals allowed by law. Prescription Only

Medicines are supplied by pharmacies; they can also be supplied in hospitals, by doctors and (to

animals) by vets.

The prescriber assesses a person’s symptoms and medical condition and decides which medicine

is the most appropriate for treatment. The prescriber will then write a prescription for that medicine.

Prescriptions are legal documents. They may be written using either by writing on a prescription

form, or printed from a computer.

Some prescribers are not allowed to write prescriptions for all types of

medicines. For example, dentists are only able to prescribe medicines that

relate to dental treatment (e.g. pain relievers and antibiotics); optometrists are

able to prescribe medicines from a specified list of medicines that relate to the

diagnosis and treatment of conditions of the eye.

Your pharmacist will know the medicines which are permitted in these

situations.


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Examples of prescriptions

Before we look at the important steps that need to be followed when you accept a prescription from

a customer, we shall look a little more closely at a typical prescription and identify the different

requirements, features and sections on a prescription.

On the following pages contain an example of a computer-generated prescription and a

handwritten prescription. Some prescriptions may differ slightly but, in general, they follow these

formats.

Computer-generated prescription

A computer generated prescription is produced when a doctor, usually a general practitioner, types

the details of the medicine they wish to order into a computer and prints the prescription onto

specially printed prescription paper.

Two copies of each prescription are produced, and the doctor must sign both copies.

The copy on the right is signed by the customer when they receive a medicine, this copy may be

sent to Medicare Australia or kept by the pharmacy.

The copy on the left serves as a duplicate prescription and may be returned to the customer – if

repeat supplies are authorised on the prescription, otherwise it will be kept by the pharmacy.


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Handwritten prescription

Prescriptions may also be written by hand. The example below is for a hand-written prescription

from a doctor, but you may also see handwritten prescriptions from dentists, optometrists, nurse

practitioners and other prescribers.

Dr ALEX SAMPLE 1254 EXAMPLE STREET SAMPLETOWN NSW 2111

1 2 3 4 5 6 7

Patient’s Medicare no. 3 2 1 3 5 4 3 2 1 1 1

Patient’s name and address

First name Family name

Mrs Mary Citizen 1 Nowhere Street, Somewhere 2112

Pharmaceutical benefits entitlement number

(tick appropriate boxes)

PBS RPBS Brand substitution not permitted

Pharm

acis

t/patient

copy

Atorvastatin 40mg tablets

1 daily

Qty 30. 5 repeats

(one item only)

Doctor’s signature

Alex Sample Date

30 / 03 /201X

Please turn over for privacy note

I certify that I have received this medication and the information relating to any entitlements to free or concessional pharmaceutical benefits is not false or misleading.

/ / __________________________________________________________

Date of supply Patient’s or agent’s signature

__________________________________________________________ Prescription is valid

for 12 months Agent’s address

These prescriptions also feature and original and duplicate copies. One copy may be sent to

Medicare Australia; the second copy may be returned to the customer if repeat supplies are

authorised.

Other handwritten prescriptions which you may see can include hospital prescriptions and

Prescribers Bag (Doctors Bag) Order Forms (see below).


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These two examples represent the prescription forms you are most likely to see, however, when

accepting prescriptions, you may see other forms or types of prescriptions. The types of

prescriptions that are currently in use may vary from state to state. However, in most states, you

are likely to come across the following types of prescriptions:

Type Description

Pharmaceutical Benefits

Scheme (PBS)

prescription forms

Handwritten prescriptions written by a doctor (medical practitioner) are

white with a yellow stripe with a top (original) and bottom (duplicate)

copy. See example on page 16.

Computer generated prescription forms are green and white. See

example on page 15

Dental PBS prescription

forms

Prescriptions from dentists look similar to handwritten prescriptions from

doctors except they are white with a light blue stripe.

Authority PBS

prescriptions

PBS Authority Required prescriptions may be computer generated and

look exactly like other computer generated prescriptions, but with a little

bit more information on them.

They may also be handwritten on special authority prescriptions forms

which are blue and white. Or they may be prescribed on hospital

prescriptions.

PBS Authority prescriptions are required to have additional information

including an authority number, and a telephone approval code or a

streamline authority code.

Prescribers’ Bag (Doctors’

Bag) Order Forms

These forms are used by doctors to obtain supplies of medicines for use

in emergencies. Doctors are able to obtain emergency supplies once a

month. Ask your pharmacist or workplace supervisor to see examples of

these forms.

Repeat Authorisation

Forms

Repeat Authorisation Forms (sometimes just called repeats) are

produced by the pharmacy when the prescriber has ordered that a

medicine may be supplied more than once.

A new form is generated every time a supply is made if a further (repeat)

supply is still available. The Repeat Authorisation Form is attached to a

copy of the original prescription, which is called the ‘Patient/Pharmacist

copy’.

The customer must present both copies (the repeat form and the copy of

the original prescription) in order to have their repeat prescription

dispensed.

Repatriation prescriptions Prescriptions for customers who are able to receive medicines

subsidised by the Department of Veterans’ Affairs are now usually

written on PBS white/yellow prescription forms, or on green/white

computer generated forms.

Private prescriptions Private prescriptions (see page 29) may be written on PBS prescription

forms or sometimes on other paper (e.g. doctor’s letterhead) as long as

the doctor’s name, address and contact details are present.


NATV3 230316 Page 18 of 78

Type Description

Public Hospital

Prescriptions

These look different to other PBS scripts, but they still are valid PBS

scripts. Ask your pharmacist if you have an example to look at.

Private Hospital or other

institution prescriptions

Some private hospitals have their own prescription forms which may

differ in appearance. Check ow they look; check with your pharmacist if

you have any examples to look at.

Closing the Gap (CTG)

prescription

Some Aboriginal and Torres Strait Islander people are able to receive an

additional subsidy on the supply of prescription medicines. These

prescriptions may also be handwritten or computer-generated.

Speak to your pharmacist or workplace supervisor. What are the most common

types of prescriptions received by your pharmacy? List these below

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Legal and professional requirements of a valid prescription

The information on a prescription must comply with legal and professional requirements. When

accepting a prescription, you should ensure that the following information is included on the

prescription.

Requirement Description

Name, address and

telephone details of the

prescriber

The Prescriber is the doctor, dentist or veterinary surgeon, or other

approved prescriber that is prescribing the medicine. The prescription

must also contain a contact number of the prescriber. The prescriber

number is a number allocated under the PBS to the prescriber. It is

usually found under the name and address.

PBS prescriber number Prescriptions written under the Pharmaceutical Benefits Scheme (PBS)

must also contain the PBS prescriber number of the prescriber.

This is usually printed top left, below the prescribers’ name and

address.

Name and address of the

patient.

Only one person’s name can be written on a prescription.

Date of prescribing Prescriptions are generally only valid for six or twelve months,

depending on the medicine prescribed and state the pharmacy is in.

Prescriptions must not be forward dated.


NATV3 230316 Page 19 of 78

Requirement Description

Medicine. This information should include the name, strength, form, quantity and

method of administration. The pharmacist will check this information.

Number of repeats. This information should only be included if repeats have been provided.

Prescriptions must be

written in ink

This is either in the Prescriber’s handwriting or computer generated. If

the prescription is computer-generated it must be signed in ink.

All prescriptions must be

signed by the Prescriber

In their own handwriting, including computer generated prescriptions.

Controlled Drugs must

have the quantity and

number of repeats (if any)

written in both words and

numerals

The pharmacist will check this information.

Veterinary prescriptions

must have “For Veterinary

Use Only” written on

them

Veterinary surgeons cannot prescribe medicines for human use.

Dental prescriptions must

have “For Dental Use

Only” written on them

Dentists may only prescribe medicines for conditions relating to dental

health.

Midwives and Nurse

Practitioners

There may be other restrictions for different types of prescribers such

as midwives and nurse practitioners. Check with your pharmacist if you

are unsure.

In order to receive subsidy under the Pharmaceutical Benefits Scheme (PBS), two copies of the

prescription must be provided (original and duplicate). If only one copy of the prescription is

supplied, then the customer may still be able to receive the medicine, but may be required to pay

the full price. Check with your pharmacist if you encounter this situation.

The legal requirements for prescriptions may differ slightly from state to state. You should check

with your pharmacist or workplace supervisor to ensure that you understand the specific

requirements for your state.

If you receive a prescription from a customer and you are unsure whether it is complete or valid,

always check with your workplace supervisor, a dispensary assistant or a pharmacist.


NATV3 230316 Page 20 of 78

Subsidising the cost of prescription medicines

The Pharmaceutical Benefits Scheme (PBS) is a scheme that helps to provide Australians with

timely, reliable and affordable access to necessary medicines.

By subsidising prescription medications through the PBS the Australian Government recognises

that correct use of prescribed medicines:

Is an important part of the treatment of many medical conditions,

Can improve the health of people

Can save the community money from reduced medical costs, hospital admissions and early

death.

Under the PBS, the government subsidises the cost of medicine for most medical conditions. Most

of the listed medicines are dispensed by pharmacists, and used by patients at home. The PBS also

covers the cost of some prescriptions provided in hospitals.

A similar scheme, the Repatriation Pharmaceutical Benefits Scheme (RPBS) provides subsidised

medicines and some other products such as wound dressings to veterans (former members of the

armed forces and their families). The RPBS is discussed further on page 28.

Finally, there are some medicines which are not subsidised on the PBS or the RPBS. These

prescriptions are termed private prescriptions and are discussed in this section on page 29.

This diagram summarises the subsidy of prescription medicines in Australia.

Prescription medicines

Subsidised by the Australian Government

Pharmaceutical Benefits Scheme

(PBS)

Repatriation Pharmaceutical

Benefits Scheme (RPBS)

NOT subsidised by the Australian Government (Private prescriptions)


NATV3 230316 Page 21 of 78

The Pharmaceutical Benefits Scheme (PBS)

Your customers will regularly ask you questions about the cost of prescription medicines, so it is

important that you understand the PBS and how it helps Australian with the costs of medicines.

Most prescriptions written in Australia and dispensed in community pharmacies are subsidised by

the Pharmaceutical Benefits Scheme.

Some medicines cost more than the price the customer pays; some medicines cost hundreds of

dollars. For example a prescription for insulin used in diabetes has a real cost of over $200, and

some medicines are even more expensive. When a medicine is prescribed and dispensed under

the PBS customer makes a part-contribution (co-payment) to the cost of the medicine, and the

Australian Government pays the remainder of the cost of supplying the medicine.

The amount the customer pays is determined by the government each year. Australians who hold

a concession card or pension card pay a reduced co-payment; Australians who do not hold a

concession card pay more. Customers who do not hold a concession card are usually referred to

as general customers.

In addition the PBS Safety Net is available to help people who use a lot of medicines over a

calendar year. The unit looks at the different concession cards and the PBS Safety Net scheme

later in this section. For some medicines there may be extra charges such as brand price

premiums, these are also discussed later in the unit (page 48).

Eligibility

All Australian citizens, who reside in Australia are eligible to receive medicines under the PBS. The

customer shows their Medicare card or Veterans Affairs card to prove they are entitled to receive

PBS (or RPBS) medicines.

Some overseas visitors are also eligible to receive PBS medicines. People who are visiting

Australia and are citizens of countries that have a reciprocal health care agreement with Australia,

are also able to receive medicines subsidised on the Pharmaceutical Benefits Scheme.

Countries with which Australia has a reciprocal health care agreement include:

New Zealand

The United Kingdom

The Republic of Ireland

Belgium

Finland

Italy

Malta

The Netherlands

Norway

Slovenia

Sweden

Visitors from these countries will generally pay up to the general co-payment amount when they

receive PBS medicines. They do not receive medicines at the ‘concessional’ price. These

customers would show their passport or other national identification to prove they are entitled to

receive PBS medicines.

Customers visiting Australia from countries that are not on this list do not receive a PBS subsidy.

They are required to pay the full cost of prescribed medicines.

Note, prescriptions for overseas visitors must be written by an Australian doctor. Prescriptions from

overseas doctors are not valid for dispensing in Australia.


NATV3 230316 Page 22 of 78

Pricing of PBS prescriptions

Under the PBS, the maximum cost for a pharmaceutical benefit item at a pharmacy is $38.30 for

general patients and $6.20 for concessional patients, plus any applicable special patient

contribution, brand premium or therapeutic group premium. These fees are set by the Australian

Government and are reviewed each year. New charges apply from 1 January each year.

The co-payment that a customer pays often does not cover the true cost of the medication. Many

PBS medicines cost a lot more than the co-payment amount. The Australian Government pays the

remaining cost.

The amount paid by the customer, plus the amount paid by the Government goes to the medicines

manufacturer, the pharmacy wholesaler and the pharmacy, to cover the costs of producing,

distributing and dispensing the medicine.

To help customers to understand the real cost of medicines the full cost of a PBS subsidised item

is shown on the dispensing label.

ADALIMUMAB 40mg/0.8mL INJECTION 2

(HUMIRA)

Inject as directed every two weeks.

STORE IN REFRIGERATOR.

MR VAN NGUYEN 30/03/1X Dr Simon WALTERS 914102 $38.30 KEEP OUT OF REACH OF CHILDREN Full cost $1763.56

Yourtown Pharmacy 78 Diamond Drive, Clarence Gardens SA 5039 Ph: (08) 83XX XXXX

Optional PBS co-payment discount

From 1 January 2016, pharmacists have the option to discount the PBS patient co-payment by up

to $1.00 (unless the prescription is an early supply of a specified medicine, in which case, the full

co-payment applies).

Pharmacies do not have to provide this discount to customers. If pharmacies do provide this

discount the pharmacy pays for the discount, not the Government.

For the following types of customers, how much would they pay for a PBS

(or RPBS) listed medicine? Check with your pharmacist or workplace supervisor if

necessary. Complete the table below.

Price without

co-payment

discount

Price with

co-payment

discount

Australian citizens (general customers) $ $

Concession card holders $ $

Eligible veterans and war widows $ $

People from other countries with health care agreements with Australia? $ $


NATV3 230316 Page 23 of 78

Five features of the Pharmaceutical Benefits Scheme

The PBS provides timely, reliable and affordable access to necessary

medicines for Australians through community pharmacies.

The Scheme is available to all Australian residents who hold a current

Medicare card. It is also available to some overseas visitors.

The PBS Schedule is a list of the medicines subsidised by the

Pharmaceutical Benefits Scheme. Not all medicines are subsidised.

The PBS Schedule specifies the quantity and number of repeats of each

medicine that a prescriber is able to order. It also specifies any

restrictions on the availability of a medicine.

The PBS also covers the supply of some medicines in public and private

hospitals.

PBS Safety Net

If a customer or their family needs a lot of medicines, the PBS Safety Net Scheme helps to meet

these costs. Once a customer and their family has paid a certain amount for PBS medicines during

a calendar year, the customer receives a PBS Safety Net card which provides them with cheaper

(or free) medicines for the rest of the calendar year.

The amount that the customer (and family) has to spend reach each year is called the PBS Safety

Net threshold. The way that the PBS Safety Net Scheme works is a little different depending on

whether the customer is a general patient or a concession card holder.

General customers Once the customer (including their immediate family) has spent an

amount equal to the General Safety Net threshold (see below) on PBS

medicines in a calendar year, they are issued with a PBS Safety Net

Concession Card. The card number starts with the letters CN.

This card allows them to receive PBS prescriptions at the current

concessional co-payment rate, plus any applicable premiums, for the

remainder of the calendar year.

Concession card holder Once the customer (including their immediate family) has received 60

PBS medicines in a calendar year, they are issued with a PBS Safety

Net Entitlement Card. The card number starts with the letters SN.

This card allows them to receive PBS prescriptions for free, plus any

applicable brand price premium, for the remainder of the calendar year.

There are a number of exceptions to the way PBS Safety Net calculations apply

Early supply rule – The PBS early supply rule applies to discourage customers from obtaining

medicines more often than needed. Most medicines for long-term conditions are prescribed in

quantities that allow for treatment of 28 days, 30 days or longer.


NATV3 230316 Page 24 of 78

If a customer wishes to receive a long-term medicine within 20 days since the medicine was last

dispensed this is permitted, however:

The patient contribution will not count towards the Safety Net threshold

The PBS co-payment cannot be discounted by the pharmacist

If the Safety Net threshold has been reached, the usual patient payment applies - not the

reduced Safety Net amount.

Premiums – Premiums are additional charges which are added to the cost of PBS (and RPBS)

medicines; a common example is the Brand Price Premium. These premiums are not subsidised

by the government and must be paid by the customer. The cost of the premiums does not count

towards a customer’s PBS Safety Net threshold.

Co-payment discount – Concessional customers who take the $1 discount must still spend the

same total amount during the year to access free medicines on the PBS Safety Net. If a customer

takes the $1 discount they will need to fill an additional eleven (11) prescription during the year

before accessing free medicines on the PBS Safety Net.

2016 thresholds for the Safety Net are shown in the following table:

General patients Concession card holders

Patient contribution

The standard maximum price

paid by a customer for a PBS

medicine.

Up to $38.30* $6.20*

Safety Net Threshold

The total amount the customer

(and family) must pay before the

PBS Safety Net applies.

$1,475.70

$372.00

(60 prescriptions at $6.20,

72 prescriptions at $5.20)

Safety Net patient

contribution

Once a customer has reached

the PBS safety Net threshold,

and has received a PBS Safety

Net card, this is the price they

pay for a PBS medicine.

$6.20* Free*

*Please note that the threshold amount changes every year.

Check with your pharmacist or on the Medicare website for your current year’s threshold

amounts at:

http://www.pbs.gov.au/info/healthpro/explanatory-notes/front/fee


NATV3 230316 Page 25 of 78

Safety Net Card examples are shown below, they are issued by the pharmacy after completion of

an application form.

Who is a Safety Net Family?

The PBS Safety Net applies to a customer and their immediate family. For PBS Safety Net

purposes a family includes:

Medicare Card

Holder

Spouse or de facto partner - for example husband and

wife.

Dependent child - Must be under the age of 16 and be

wholly or substantially in the care of the Medicare

cardholder or their husband/wife or de facto partner.

Dependent student - must be under the age of 25

years, study full time and or wholly or mostly dependent

on the Medicare cardholder or their husband/wife or de

facto partner.


NATV3 230316 Page 26 of 78

Other PBS Safety Net matters

PBS cards are generally issued by community pharmacies during the dispensing process. They

can also be issued by Hospital Pharmacy Departments and Medicare Australia offices.

Customers who lose their PBS Safety Net card can request a new one from Medicare Australia.

Concession cards and PBS Entitlement cards affect the amount of money that your customers pay

for their medicines, and also the amount of money the pharmacy receives from the government. It

is important to check and correctly record a customer’s concession and entitlement details when

accepting a prescription for dispensing.

The amount that a person or family spends on PBS medicines can be added together from a

number of pharmacies and hospitals to combine to reach the total PBS Safety Net threshold. Each

pharmacy or pharmacy department provides a record of the money paid for each prescription on a

Prescription Record Form (PRF). The pharmacy that issues the PBS Safety Net card collects all

the PRFs, checks the total, issues the Safety Net card, and posts the PRFs away to Medicare

Australia for verification.

If a customer or their family spends more than the PBS Safety Net threshold the pharmacy can

issues a PBS receipt which the customer can use to claim a refund from Medicare Australia. The

pharmacy is not able to process these refunds.

Some families consist of a combination of general and concession customers. For example the

mother and father are general customers, but one (or more) children hold a Health Care Card

because of that child’s disability. The PBS threshold is calculated slightly differently for these

families. Check with your pharmacist if unsure.

Although you may be familiar with, and understand the meaning of,

words ‘entitlements’, ‘concessions’ and ‘PBS Safety Net card’,

customers may not fully understand what these words mean. You may

need to ask your customer very clear questions, or ask a question in a

different way or using different words, to ensure that the customer

receives the benefits they are allowed.

Having a picture or poster of accepted cards at the counter may help

you when accepting prescriptions.

This unit covers the process of checking for concession cards later in this learner guide on page

46.

Example:

You ask Mrs Lee if she has a concession card. She states that she does not

have one.

When she receives her dispensed medicines she complains about the price

charged. You find that she did have a Health Care card, which she did not show

you.

Because you have used the words concession card instead of Health Care card

she did not understand what you meant.


NATV3 230316 Page 27 of 78

How much does a general customer need to spend before they are entitled to a

Safety Net Concession Card? How much do PBS medicines then cost? Check with

your pharmacist or workplace supervisor if necessary. Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

How much does a concession cardholder need to spend on medicines before they

are entitled to a Safety Net Concession Card? Check with your pharmacist or

workplace supervisor if necessary. Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Closing the Gap

The Closing the Gap PBS Co-payment program is one of a number of

government measures to improve the health of Aboriginal and Torres

Strait Islander people living with, or at risk of, chronic disease. The

scheme reduces the cost of PBS medicines for eligible Aboriginal and

Torres Strait Islander people. It has operated since July 2010.

The Closing the Gap PBS Co-payment Programme is available to Aboriginal and/or Torres Strait

Islander people of any age who present with an existing chronic disease or are at risk of chronic

disease, and in the opinion of the prescriber:

Would experience setbacks in the prevention or ongoing management of chronic disease if the

person did not take the prescribed medicine; and

Are unlikely to take their medicines as prescribed without assistance through the programme.

How it works

Prescribers must write on the prescription with the letters 'CTG', their initials and signature. This

may be done on handwritten prescriptions or computer generated prescriptions. When dispensing

the prescription at the pharmacy the pharmacist or dispensary assistant indicates the patient and

the prescription has CTG status. The dispensing software adjusts the price charged to the patient,

and the amount of money claimed from Medicare Australia to subsidise the supply of the medicine.


NATV3 230316 Page 28 of 78

When obtaining PBS medicines at their local pharmacy:

Eligible general customers who would normally pay the full PBS co-payment (currently $38.30

per item) pay the concessional rate (currently $6.20 per item).

Those who would normally pay the concessional price receive their PBS medicines without

being required to pay a PBS co-payment.

A pharmacy staff resource booklet that explains the Closing the Gap scheme is available from this

link:

http://www.pbs.gov.au/publication/factsheets/closing-the-gap/ctg-pbs-co-payment-measure-

pharmacy-staff-resource-booklet-2015.pdf

Repatriation Pharmaceutical Benefits Scheme

Most Australian citizens are covered by the Pharmaceutical Benefits Scheme

and receive their medicines according to the rules, schedules and subsidies of

the PBS. However there is another scheme which assists with the subsidy of

prescription medicines for some Australians.

The Repatriation Pharmaceutical Benefits Scheme (RPBS) covers the

medicine needs of veterans. Veterans are people who previously served in the

armed forces (army, navy and air force servicemen and women) and their

widows. This scheme is paid for by the Australian Government Department of

Veterans’ Affairs (DVA).

The entitlements under the RPBS are similar to those of the PBS, as is the

method of processing a prescription, but there are some notable differences:

The cards are different. There are Gold, Orange and White DVA cards.

In most cases veterans do not hold Medicare Cards.

The medicine entitlements are different. People who hold Gold or White DVA are entitled to all

of the medicines in the PBS schedule, plus some additional medicines, skin products and

wound dressings which are listed separately in the Repatriation Schedule of Pharmaceutical

Benefits (RPBS Schedule).

These prescriptions are coded slightly differently. You will notice that once the prescription has

been dispensed the pharmacist will place a sticker which carries the prefix “R” followed by a

number.

However other PBS rules apply, for instance:

The PBS Safety Net also applied to DVA card holders and their families.

DVA card holders can be combined into a PBS Safety Net family along with other Medicare

Card (non DVA) family members.

Customers who hold a Repatriation (DVA) benefit card are also required to pay the various

prescription premiums and surcharges.


NATV3 230316 Page 29 of 78

Private prescriptions

A private prescription or non-PBS prescription is a medicine which is not subsidised by the

Pharmaceutical Benefits Scheme (or the RPBS).

There may be a number of reasons why an item is not subsidised for a patient, these include:

The medicine is not listed as a subsidised item (it does not appear in the Schedule of PBS (or

RPBS) Benefits)

The customer is not entitled to PBS medications (i.e. the customer does not hold a Medicare

Card, for example they may be a visitor from another country).

The medicine may sometimes be available on the PBS, but not for the treatment of this

customer’s medical condition.

The medicine may sometimes be available on the PBS, but the prescriber has ordered a

quantity (or number of repeats) which is greater than the standard PBS quantity.

Sometimes the prescription will be marked “NON-PBS” or “PRIVATE PRESCRIPTION” or similar

words. Once you have a little more experience you will begin to recognise commonly prescribed

medicines which are private prescriptions.

Medicines can vary in price from a few dollars to several hundreds of dollars or more. For private

prescriptions the customer may ask in advance for an indication of how much the medicine will

cost. You can check this with a pharmacist or dispensary assistant.

Sometimes a customer who is having a private prescription dispensed will ask for an official

receipt. This is a special receipt which is produced at the time of dispensing. Depending on their

circumstances, the customer may use the receipt to claim a rebate or refund from private health

insurance, their employer or for taxation purposes.

If a customer asks you for a receipt, ensure that this is clearly marked according to your

pharmacy’s procedure, by use of a prescription check slip or other note.

Accepting prescriptions


Areas of the pharmacy where prescriptions are accepted, dispensed and returned

The process of dispensing a prescription

The role of the pharmacy assistant

The steps involved in checking details and information on a prescription

Information about generic medicines

Responding to problems identified with prescriptions

Passing information on to the pharmacist

Prescriptions by telephone

Prescriptions held on file at the pharmacy


NATV3 230316 Page 30 of 78

Areas of the pharmacy where prescriptions are prepared

Dispensing prescribed medicines is one of the most important services that a community pharmacy

provides. The area where prescription medicines are stored and prepared is called the dispensary.

There are also other areas of the pharmacy that are important to the storage, display, preparation

and supply of medicines. These are:

Professional Services Area

Prescriptions in/out counter

Counselling area and/or consultation room

Dispensary

Professional Services Area

The Professional Services Area is the area of your pharmacy where medicines are displayed and

stored, and where professional advice and services are provided. The Professional Services Area

includes the dispensary, the prescriptions in/out counter, counselling areas and any consultation

rooms where professional services are provided. Customers should be easily able to see a

difference between the Professional Services Area and the general trading area of the pharmacy.

All scheduled medicines – Pharmacy Medicines (S2) and above – must be stored in the

Professional Services Area.

Some pharmacies have policies (rules) about which pharmacy staff members may usually work in

the Professional Services Area. For example, in some pharmacies only pharmacy assistants who

are trained in the supply of Pharmacy Medicines and Pharmacist Only Medicines may work within

the Professional Services Area.

Prescriptions in/out counter

Most pharmacies have a particular counter where customers hand in prescriptions for dispensing.

In some pharmacies there are separate counters for prescriptions in and prescriptions out. Your

regular customers will know the area in the pharmacy where prescriptions are accepted, however,

you may find that new customers may need to be directed to the area and guided through the

process.

If a customer tries to present a prescription for dispensing at a different counter (e.g. cashier) or

approaches you with a prescription, they may be unfamiliar with your pharmacy’s layout or

procedures. Walk with the customer to the prescriptions in counter, assist them by accepting their

prescriptions and point out where they can wait and from where they can collect their prescriptions.

Some customers may be hesitant or nervous about having a prescription filled. If you show a

caring and helpful attitude, you will help them become more relaxed and comfortable with the

process. Although it is important that the process of accepting a prescription should be done in a

timely manner, you should not rush the process. Customers should feel cared for and should value

the service your pharmacy offers.


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Counselling area and/or consultation room

The counselling area and consultation room are areas where pharmacists and pharmacy

assistants can have private conversations with customers. These areas are often located close to

the dispensary. In some pharmacies the prescriptions out counter is divided by partitions to provide

additional privacy.

If a pharmacist is speaking with a customer in a counselling area you should generally not listen in

or interrupt the conversation. However you should stand ready to assist the customer and take

over serving the customer when indicated by the pharmacist.

Dispensary

The dispensary is the area of the pharmacy where prescription medicines are stored, where

prescriptions are dispensed and prepared and where dispensed medicines are stored before

collection by customers. Sometimes Pharmacist Only Medicines and Pharmacy Medicines are also

stored in the dispensary. The dispensary includes the Controlled Drugs safe, the medicines

refrigerator and any area used to prepare dose administration aids.

To maintain security and confidentiality some pharmacies have policies (rules) about which

pharmacy assistants are permitted into the dispensary. For example, in some pharmacies only

qualified dispensary assistants are allowed to enter the dispensary.

Speak with your pharmacist or workplace supervisor. Does your pharmacy have

any particular rules about who may enter the dispensary and the purpose for which

people can enter? Does your pharmacy have any particular rules about which

pharmacy assistants may usually work in the Professional Services Area? List

these below

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

The process of dispensing a prescription and the role of the pharmacy assistant

The process of accepting and delivering medicine to your customers has a number of different

steps (see below). These steps involve the customer, the pharmacist and you.

The flow chart below shows an example of the process of accepting a prescription, and delivering

medicines to customers. However, note that every pharmacy is different, and you should become

familiar with the roles and procedures which are relevant in your pharmacy.


NATV3 230316 Page 32 of 78

The chart will help you to have clear understanding of your role and responsibilities. It is also

important for you to understand the steps that a pharmacist must take when providing medicines to

customers. Although it is natural that you will want to provide your customers with as much

information and assistance as possible, it is important that you understand that there are very strict

limits to the information that you can provide.

The role of the pharmacy assistant includes providing information and advice to meet the health

needs of their customers. Pharmacy assistants may be called upon to advise customers about

products sold in the pharmacy, but this advice must not include medical assessment or counselling

about a medical condition. A pharmacy assistant works under the direction and supervision of the

pharmacist. If any judgement or advice of a legal, professional or therapeutic nature is required,

the customer must be referred to the pharmacist.

The pharmacist is the only person in the pharmacy who can advise customers about their

symptoms, medical conditions and medicines. They have been specially trained to understand a

customer’s symptoms and conditions and then provide information and advice on medicines that

can assist them.

It is not your role to provide customers with information on their medical condition or attempt to

diagnose their symptoms. You are not able to provide them with information and advice on the

Prescription Medicines they receive.

Customer

• is greeted by pharmacy assistant

• hands over prescription to pharmacy assistant

Pharmacy assistant

• checks prescription and asks questions to confirm customer details and requirements

Pharmacy assistant

• passes prescription to pharmacist and relays important information from customer

Pharmacist

• may speak to customer regarding mediciine, symptoms or concerns

Pharmacy assistant

• tells customer of expected waiting time

Pharmacist (or dispensary assistant)

• checks prescription, selects required medicines and produces labels

Pharmacist

• checks and places medicine, prescription and other documentation in container for collection

Customer

• returns to collect dispensed medicine(s)

Pharmacy assistant

• retrieves dispensed medicines from the dispensary

Pharmacist

• provides final check of medicine and provides information, advice and counselling to customer

Pharmacy assistant

• completes other actions and finishes sale


NATV3 230316 Page 33 of 78

Your important role is to ask the customers questions, listen closely for their responses and then

decide if you should refer them to your pharmacist.

The Pharmacist The Pharmacy Assistant

Is an important source of expert

advice

Assesses the customer’s health

and needs

Provides medicines and health

care advice

Assesses whether a customer is

using a medicine correctly.

Considers whether a medicine is

working as expected.

Refers customers to a doctor

where appropriate.

Records and follows up advice

as required.

Is an important link between the

pharmacist and the customer

Provides general product

knowledge and advice to the

customer

Refers customers with

symptoms, medical conditions or

queries about medicines to the

pharmacist

Checking details when accepting a prescription

One of the most important steps when dispensing a prescription for a customer is checking that all

of the details relating to the customer and their prescription are clear, complete and correct. This

step is important in ensuring that the pharmacist has all the information that they need to dispense

the medicine.

If the information on the prescription is not clear, complete or correct, a number of things could

happen.

The customer could receive the incorrect medicine,

The customer could be charged the incorrect amount,

The medicine could be given to the wrong customer,

The pharmacy may not receive the correct payment from the government

The pharmacist may not be able to dispense the medicine until the customer returns to the

pharmacy and the information is obtained or confirmed.

Some of these situations could cause great harm to your customers and damage your pharmacy’s

reputation.


NATV3 230316 Page 34 of 78

All of the details on all of the prescriptions need to be checked all of the time.

It is not good enough to check the customer’s address and not the

doctor’s details; or to check the entitlement number but not the expiry

date.

It is not good enough to check some customers’ prescriptions, but when

you are busy, not to check others.

And it is not good enough to check new or unknown customers’

prescriptions and simply accept prescriptions from regular customers.

The following is an outline of the basic information that needs to be checked before a prescription

can be accepted and passed to the pharmacist. These guidelines will change from state to state

and individual pharmacies may have their own guidelines. You should check with your pharmacist

or workplace supervisor to ensure that you understand the information you should be collecting

and checking when accepting a prescription in your pharmacy.

A recommended approach for obtaining and checking prescription details

Described below is a nine-step process which you can use to check and confirm customer

information. By following this process, you should gather or confirm all the information a

pharmacist requires to dispense a customer’s prescription.

As you speak with your customer you may wish to advise the customer that the pharmacy checks

and gathers this information including their personal details in order to safely and legally dispense

the prescription.

1. Check:

•Greet the customer

•Who is the prescription for?

2. Check

•Customer's name and address

3. Check

•Customer's history and medical details

4. Check

•Prescription date and validity

5. Check

•Medicare or DVA number

6. Check

•Entitlement and/or Safety Net number

7. Check

•Items required by customer

8. Check

•Preferred brand

9. Check

•Waiting time


NATV3 230316 Page 35 of 78

The process of accepting a prescription in more detail

This section of the learner guide examines in more detail what you have to do when you accept a

prescription from a customer. It is based on the 9 aspects that you need to check when accepting a

prescription.

1. Check and confirm who the prescription is for

Your first action is to greet the customer and ask about the customer’s

requirements. This may sound obvious, but you can make your

pharmacy a much more welcoming place to visit through the way you

interact with customers.

You can also use this as an opportunity to remind customers that the questions which you ask are

done so in order to safely fill their prescription, to meet the pharmacy’s legal requirements and to

ensure the customer is charged the correct price for their prescription.

Sometimes the conversation will be obvious:

Good morning, how can I help you?

I would like this prescription filled please.

Certainly, is the prescription for yourself?

Yes, the prescription is for me.

No, it’s for my husband, child, baby, neighbour.

And sometimes not:

Sometimes customers don’t always communicate the way you would like them to. This may be due

to language or cultural barriers, physical or learning disabilities, or tiredness or rudeness, but with a

little effort and politeness you can usually obtain the information you need.


NATV3 230316 Page 36 of 78

Think of a time when you have had difficulty communicating with a customer. What

was the reason for the difficult conversation? (e.g. language, culture). What do you

do in situations like this to ensure you can communicate effectively with customers?

Describe the situation below, and list one suggested approach to improve

communication with the other similar customers

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

It is important at this stage to check that the prescription is for the person who has presented the

prescription. There will be times when the prescription will be for another person such as the

customer’s child, parent or friend.

By asking the customer: “Is this medicine for you?” you will be able to find out if the

medicine is for another person. If you find that the medicine is for another person,

you will need to let the pharmacist know.

This information is important to the pharmacist as they may change the questions

they ask and the counselling advice they provide based on who is collecting the

prescription. In some cases the pharmacist may include additional written

information, or make a telephone call to speak directly with the customer.

The information is also important to you because it may change some of the

questions that you ask in the next checking stage.


NATV3 230316 Page 37 of 78

2. Check and confirm the customer’s name and address

The next checking step when accepting a prescription is to check and

confirm the name and address information on the prescription.

Name: The pharmacist or the dispensary assistant uses the name on the prescription to access

dispensing records, to record the supply of a medicine, and to produce labels for the medicine.

You may encounter the following difficulties:

Handwriting on the prescription is difficult to read

The names on the prescription are common ones such as “Smith” or “Nguyen”.

The customer’s first name is abbreviated, e.g. Mr F. T. Green.

It is unclear whether the prescription has been written for a child or an adult.

You should check the name of the person on the prescription, even if the prescription has been

computer-generated. Sometimes customers hand you a prescription for their partner or a family

member when they really intended to have a prescription filled for themselves.

Confirming the customer’s name and correct spelling helps to avoid any confusion and reduce the

risk that a medicine could be dispensed to the wrong customer.

Action to take:

Politely and discreetly ask your customer their name.

If the handwriting is particularly difficult to read, or if you are still unsure, it is best to ask the

customer to spell their name.

Check both first and last names. The customer’s full first name, as well as preferred name is

important to help the pharmacist or dispensary assistant identify customers who have the

same surname.

Sometimes, where a pharmacy has many customers with the same first name and surname,

they will add a patient’s middle name into the record to ensure the medicine is dispensed to

the correct person.

I need to confirm some details before we dispense your

prescription…

Is your name Sandra Douglas?

Address. The customer’s address details are vital to the pharmacist or dispensary assistant in

processing the prescription. It is therefore important to check that the address is accurate and

complete. You will need to ensure that the address contains a number, a street name, the suburb

or town and postcode. You may find the following problems;

Missing or incomplete information – e.g. address not written on prescription.

Changed information – e.g. the customer has recently moved address, information on a repeat

form is inaccurate.

Prescription has PO Box or postal address instead of physical address.


NATV3 230316 Page 38 of 78

Although you will know your regular and long-term customers, it is still important for you to check

these details on every occasion as these may have changed, and they may not have been in to

see you since this change. Remember to tell them why it is important to have this information in a

polite way.

There will be times when you have a different pharmacist or dispensary assistant working in the

pharmacy. These staff members may not know your regular customers. By checking and providing

complete customer details you help to ensure that the correct person gets the correct medicine. If

you explain why this checking is important to your regular customers, they will understand the

process a little more and accept the need to check.

Action to take:

Ask the customer for their address details, or confirm the details on the prescription.

Clarify addresses where PO Boxes are provided to obtain a physical street address.

Record any changes or clarifications according to your pharmacy procedure. This may be by

using a prescription check form, writing details on a separate note, or endorsing the

prescription form.

The address on the prescription is 10 Short Street,

Williamstown. Is that correct?

No it isn’t, we moved house last month. The new address is

31 Figtree Lane, Newport.

What procedure do you follow if you need to provide updated or additional

information to a pharmacist about a prescription? Do you use a prescription check-

slip, a sticky-note or some other method? Briefly describe your pharmacy’s usual

practice below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


NATV3 230316 Page 39 of 78

3. Check and confirm any important medical details

This check stage is the opportunity to gather important additional

information about the person for whom the prescription has been

written. This information can assist the pharmacist to dispense to

medicine safely. It also helps to build the record of medical information held by the pharmacy about

the customer.

The action that you take at this step can vary from pharmacy to pharmacy. Check with your

pharmacist or workplace supervisor about the questions you should ask about customer’s allergies

and medical history at this step.

Some pharmacies require that pharmacy staff ask customers other questions about their

health and medicines.

Some pharmacies require you to ask the customer if they have had any prescriptions

dispensed at this pharmacy in the past.

Some pharmacies also ask customers if they have any allergies or reactions to medicines.

Sometimes the customer will volunteer information which should be passed on to the

pharmacist.

In all of these cases, this information helps the pharmacist to supply the medicines to the customer

safely.

The information provided to you by the customer should be passed on to the

pharmacist in a clear and correct manner. It is not your role to interpret this

information, make judgements about a customer’s conditions or symptoms or to

change information in any way.

Take special care when passing customer information on to the pharmacist and

make sure that he/she receives accurate and correct information.

If you explain the reasons why the pharmacist needs this information, customers are usually happy

to provide these details.

In some pharmacies the pharmacist will prefer to ask these questions. You will need to check with

your pharmacist and workplace supervisor to ensure that you are asking your customers the

questions as required by your pharmacist.

Before I lodge this prescription for dispensing, could I

please ask, are you allergic to any medicines?

I see this is a newly written prescription. Have you used

this medicine before?


NATV3 230316 Page 40 of 78

Prescriptions for children

If the medicine is for a child, it is important to record date of birth, or the age of the child and pass

this information to the pharmacist.

The age of the child can affect the medicine that is prescribed and the pharmacist will need to

check that the dosage of the medicine is correct for the age and weight of the child.

If the customer is a child under 12 years most pharmacies request the date of birth of the child.

If the customer is a child under five years of age, some pharmacies also require the weight of

the child.

The pharmacist needs to know this information before he or she dispenses the medicine.

You mentioned that the prescription was for your

daughter. Could I please ask for her date of birth?

In your pharmacy, if the customer named on the prescription is a child, what

information do you obtain for your pharmacist? How do you record this

information? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Sometimes customers may be sensitive about being asked personal information, for example: the

age or weight of an older person, or whether the customer may be pregnant or breastfeeding. If a

pharmacist asks you to obtain additional personal information about the customer, make sure this

is done respectfully and privately. Customers may not wish for other customers or other pharmacy

staff to hear their personal details. Consider taking the customer to a quiet part of the pharmacy or

to the private counselling area.

In your pharmacy, what health information does your pharmacist require you to ask

your customers about? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


NATV3 230316 Page 41 of 78

List the situations when additional information should be obtained from a customer

when they present a prescription. What information do you obtain? List this

information below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

4. Check the validity of the prescription

Some pharmacy procedures will ask you at this point to do a quick

check of the validity of the prescription to ensure that it is valid.

Prescription validity is also checked by a pharmacist or dispensary

assistant in the dispensary. However, if the prescription, or repeat prescription, is out of date the

customer may experience delays if this is not identified when the script is accepted. Often a

customer who presents an expired prescription has another newer prescription in their handbag or

prescription wallet.

In most cases prescriptions and repeats are valid for 12 months. However, for Controlled Drugs

(Schedule 8 medicines) and some other medicines, prescriptions may only be valid for six or two

months. This regulation varies from state to state and you should check with your workplace

supervisor or pharmacist to ensure that you have these regulations right.

Action to take:

Carefully check the date of prescribing on every prescription to ensure that it is still valid.

If the prescription is no longer valid, ask the customer if they have a newer prescription.

If the customer does not have a newer prescription let a pharmacist know.

Depending on the circumstances they may make other arrangements to ensure the customer

does not go without their medicine.

Customers are often not aware of the dates and validity of prescriptions and may be surprised,

confused or angry. Explain clearly and calmly why the prescription cannot be accepted and

suggest that they should return to their doctor for a new prescription.


NATV3 230316 Page 42 of 78

In your state or territory, for how long are prescriptions generally valid? Write your

answer below.

Prescription Only Medicines (Schedule 4): ____________________________________________

Controlled Drugs (Schedule 8): _____________________________________________________

If there are any exceptions to these rules in your state or territory, list these below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

5. Check the Medicare or DVA card

Pharmacies are required to record a customer’s Medicare Card or

Veterans’ Affairs Card details in order to provide medicines using the

PBS or RPBS. A valid Medicare Card or Repatriation Card is proof that

the customer is entitled to subsidised prescription medicines.

You should ask customers to show their Medicare Card or

Department of Veterans’ Affairs (DVA) card whenever you accept

a prescription to be dispensed.

Most computer generated prescriptions have the customer’s

Medicare Card details printed on the prescription form, however

you should still check this information as sometimes the details

recorded by the doctor’s computer is out of date.

Read your pharmacy’s policies and procedures. In your pharmacy, what is your usual

practice when asking for and recording a customer’s Medicare Card (or DVA) number?

Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


NATV3 230316 Page 43 of 78

Regular customers of your pharmacy are likely to have their Medicare Card or DVA card details

already stored in your pharmacy’s computer. Sometimes customers become annoyed if they are

continually asked to provide the same information time and time again; however customers are

becoming used to the idea that it is necessary to show their cards every time they visit a doctor,

pharmacy, hospital or other health care provider.

Ask your pharmacist or check your pharmacy procedures. How do you ask regular

customers of your pharmacy about their Medicare or DVA details? Describe your

pharmacy’s expectations below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

More information about recording Medicare Card details

Medicare Card details must be recorded in the dispensary computer in order for customers to

receive subsidised prescription medicines under the PBS.

The customer’s Medicare Number and the expiry date of the card need to be recorded and

passed on to the pharmacist.

Each person listed on the Medicare card has an Individual Reference Number. The number on

the card to the left of the customer’s name is part of the customer’s number and needs to be

recorded. You should carefully check to ensure that you record the correct number for the

customer for whom the prescription is written.

In cases when a prescription is lodged by another person (friend, neighbour or family member)

you may need to take extra steps to check that the Medicare Card number is recorded and up

to date. Sometimes the person’s number will already be recorded on the pharmacy computer,

or printed on the prescription form; and sometimes the agent will have the customer’s

Medicare Card with them; however in other cases the pharmacy may need to contact the

customer (e.g. by telephone) to obtain their Medicare Card details.

3299 58768 4

1 DAVID J WILLIAMS

2 REBECCA C WILLIAMS

3 LILY-ANN G WILLIAMS

4 MICHAEL C WILLIAMS

VALID TO 08/2019

Medicare

Card Number

Expiry date

Individual Reference

Number


NATV3 230316 Page 44 of 78

When a prescription is dispensed through the dispensary computer the software checks the

customer’s name and Medicare Card number to ensure they are valid. Sometimes the name

on a customer’s Medicare Card is different from the preferred name the customer wishes to be

known as. For example a customer who official name is “William” may be commonly known as

“Bill”. Most dispensary software systems can record both the customers preferred name and

the official name that appears on the Medicare Card. In situations like this you should clearly

record both names.

If a customer is not able to provide their Medicare Card, it is possible for the pharmacist to ring

Medicare Australia to obtain these details. The customer needs to provide their consent to

allow the pharmacist to make this phone call. In other cases, where the Medicare Card cannot

be obtained and the prescription is required urgently the pharmacist can us a special number

to process the prescription at PBS rates.

In most cases the pharmacy will keep customers Medicare and DVA Card numbers recorded

in the dispensary computer. However the Medicare Card number does change when a card

expires and is renewed. You may need to ‘train’ your customers to present their new card

whenever the card is updated.

If a customer does not wish to show or verify their Medicare or DVA Card then the prescription

may be dispensed as a private prescription. The customer may wish to receive an official

itemised pharmacy receipt which they may be able to use to claim reimbursement from

Medicare Australia or a health insurer or travel insurer.

There may be times when a customer becomes angry or upset at the requirements to show

cards and provide information to the pharmacy. If this is the case, you should take the time to

explain the process to the customer and, if possible, explain the reasons why the pharmacy is

required to gather this information. The Australian Government requires the pharmacy to ask

for the card to ensure that only eligible customers receive the subsidised medicines.

If the customer is still having difficulty understanding the process, it may be useful to seek help

from a senior pharmacy assistant or your pharmacist.

More information about DVA Cards

For patients who receive hold cards issued by the Department of Veterans’ Affairs, the DVA Card

details must be recorded in the dispensary computer in order for customers to receive subsidised

prescription medicines under the RPBS.

Veterans and family members covered by the RPBS need to show their Repatriation Health

card (Gold, White or Orange).

Gold DVA card holders will not have a Medicare Card, they will use their Gold DVA card

instead.

White DVA card holders receive subsidised RPBS medicines only for certain conditions. For

prescriptions that are not covered by their DVA Card they will need to show their Medicare

Card and have these prescription items dispensed under the PBS.

Customers who are lodging prescribed medicines for someone else should provide that

person’s DVA number.

DVA numbers do not change when the card is updated or renewed. It is generally not

necessary to record the DVA card expiry date.


NATV3 230316 Page 45 of 78

The following table provides you with an outline of the benefits available to your customers who

have Gold, Orange and White Department of Veterans’ Affairs cards.

Card Type Benefits Example

Gold card Allows the holder to access health care

and related services for all health care

needs, for all conditions, whether they are

related to war service or not.

Orange card Allows the customer to access the range

of pharmaceutical items available under

the Repatriation Pharmaceutical Benefits

Scheme (RPBS).

White card Allows the customer to access health care

and associated services only for specified

war or service-related conditions.

More information about overseas visitors

Customers from some countries are able to receive prescribed medicines under the

Pharmaceutical Benefits Scheme (see list on page 21). If a customer states that they are a visitor

from another country you should record this information for the pharmacist.

You may wish to see their passport as evidence that they are from one of the countries with which

Australia has a Reciprocal Health Care Agreement, however it is not necessary does not hold a

Medicare Card (or DVA Card), for instance if they are a visitor from another country, then the

prescription may need to be treated as a private prescription (see page 21).

Could I see your Medicare Card please?

I don’t have a Medicare Card. I’m from England,

I am in Australia visiting my daughter for a few

weeks.

How nice. I hope you have a lovely time here.


NATV3 230316 Page 46 of 78

6. Check concession and entitlement number and details

Customers who hold an Australian concession card can receive PBS

listed prescription medicines at the concessional rate. This means that

they pay a lower co-payment compared to general patients.

Patients who hold Australian Government Concession cards

Cards that entitle the holder to receive PBS prescription medicines at the concessional rate are:

Pensioner Concession Card

Commonwealth Seniors Health Care Card

Health Care Card

See examples below.

Note, the blue and white Seniors cards issued by state or territory governments are not valid for

receiving PBS medicines at the concessional rate.


NATV3 230316 Page 47 of 78

If the customer has one of the cards listed above, you should check the card and confirm or record

the Customer Reference Number (CRN) and the card’s expiry date.

If a customer is unable to provide their entitlement or concession card, the pharmacist must charge

them the full price of the prescription. This amount can then be provided on a receipt and the

customer can claim the amount back from Medicare.

Patients who hold PBS Safety Net cards

Customers (and their family members) who have been issued a PBS Safety Net

Concession Card also receive PBS listed prescription medicines at the

concessional rate, plus any applicable premiums.

Customers who have been issued with a PBS Safety Net Entitlement Card receive

PBS listed prescription medicines at no charge, plus applicable premiums.

Once issued, PBS Safety Net cards are valid until the end of that calendar year.

You can identify the year of issue and decide whether a card is valid by checking

the first digit of the card number. For instance in 2016 customers who reach the

PBS Safety Net threshold will receive PBS Safety Net Entitlement cards

commencing with SN6… and PBS Safety Net Concession cards commencing with

CN6… The digit “6” refers to the calendar year 2016.

If a customer presents a PBS Safety Net Card you should check that their name is

listed on the card. Remember, you also need to record the customer’s Medicare Card details.

7. Check which items the customer requires

On many of the prescriptions that you receive from your customers,

there may be more than one medicine prescribed.

When a customer hands you a prescription that has more than one

medicine written on it, you need to ask the customer which items they would like to have

dispensed. Often a customer will have enough of some items at home and may wish to obtain

these medicines another day.

By asking the customer which items they require all the medicines on the prescription, you are

checking that they receive only the medicines they require. Prescriptions for medicines which the

customer does not require will be deferred by the pharmacist. The customer will receive a repeat

prescription form which will allow them to obtain the medicine at a later date.

Your pharmacy will have a system or procedure to indicate to the pharmacist which medicines the

customer requires. This may be by ticking the required items, or writing the items on a check-slip or

note. When following this system or procedure, make sure that you clearly indicate the medicines

that are required by the customer.


NATV3 230316 Page 48 of 78

Read your pharmacy’s policies and procedures. What system or procedure does your

pharmacy use to show which medicines the customer requires, and which medicines

the customer does not require on a prescription? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

8. Check the customer’s preferred brands of medicines

When a doctor writes a prescription, they may prescribe the brand

name of the medicine, or they may prescribe the generic name of the

medicine. The generic name refers to the drug or chemical name

contained in the medicine. There may be several of different brands of

that medicine available, produced by several different companies.

Some brands of medicines cost more than others. For example, Alphamox®, Amoxil®, and

Cilamox® are all different brands of the antibiotic amoxycillin. The quantity of the medicine

contained in each capsule is the same, but the price of some brands may be different1.

Since 1990, a minimum pricing policy has applied to most medicines listed on the PBS. This

means that the Australian Government will only reimburse a pharmacy for the lowest price brand of

medicine. If the doctor prescribes, or the customer chooses to receive a more expensive brand, the

customer is asked to pay the difference between the selected brand and the lowest priced one.

Brand substitution (generic substitution)

If you look at the sample prescriptions at the front of this learner guide (pages 15 and 16) you will

see that prescriptions carry a box labelled “Brand substitution not permitted”.

1 At the time of writing (November 2015) a prescription for Amoxil

® 500mg capsules costs $3.27 more than

the other benchmark priced brands.

If the doctor has:

Ordered a medicine by its brand name, and

Ticked the “Brand substitution not permitted” box,

the customer must be supplied the specific brand of medicine listed on the

prescription.


NATV3 230316 Page 49 of 78

How does the choice of different brands affect the pricing of prescription medicines?

For each prescription medicine there will be one or more brands which are the least expensive

brand. These medicines are termed benchmark priced brands. When a customer receives a brand

of medicine that contains costs more than the benchmark priced brand they are required to pay the

additional amount that the medicine costs. This may be a range from few cents up to several

dollars. The extra amount is called the Brand Price Premium.

Brand Price Premiums are required to be paid by all customers including general patients,

concession and entitlement card holders, and DVA card holders. The Brand Price Premium does

not count towards a person’s PBS Safety Net threshold.

Action to take:

When a customer presents a prescription on which the doctor has not ticked the box labelled

“Brand substitution not permitted”, you should ask the customer about their brand preferences for

their medicine.

Each pharmacy will have its own suggested words or phrases for pharmacy assistants to use.

Some pharmacies refer to generic medicines as “less expensive” brands, others use the phrase

“pharmacy preferred” brand.

For example:

Are you happy to receive the pharmacy’s preferred brand of

medicine?

Certainly. If the quality is the same and cost is less I don’t

mind.

Are you happy to receive the pharmacy’s preferred brand

of medicine?

No. I would really like to receive the brand the doctor has

prescribed.

If the doctor has:

Prescribed a medicine by brand name and has not ticked the box, or

Prescribed a medicine using the generic name of the medicine,

then the customer can be offered an identical brand that contains the same active

ingredient(s).


NATV3 230316 Page 50 of 78

When accepting a prescription for dispensing you should indicate whether:

The customer is happy to receive a similar brand to the one the doctor has prescribed, or

The customer wishes to only receive the brand the doctor has prescribed, or the brand they

have received previously.

This information needs to be passed to the pharmacist so the correct brand of medicine can be

dispensed.

Understanding more about medicine brands

Often customers are not sure about the difference between brand name and generic medicines. If

the customer appears confused when you ask about medication brand preferences, you can help

to explain more about generic medicines and their the choice of medication brands.

The table below shows the similarities and differences between brand name and generic

medicines.

Similarities Differences

Same active ingredient/s. The active

ingredient is the chemical that makes

the medicine work.

Same potential effects

Same potential side effects

Same high manufacturing quality and

safety standards set by the Australian

Government.

Known as bioequivalent

Different brand name

May have a different colour, shape or size

May have different inactive ingredients,

including lactose, dyes and gluten,

(Customers may be sensitive to active and/or

inactive ingredients in a medicine).

Different packaging

Different costs – generic medicines usually

cost less than original brand name

medicines. To learn about possible cost

differences, advise the customer to speak to

the pharmacist.

Further information on generic medicines can be obtained from the following website:

http://www.nps.org.au/topics/how-to-be-medicinewise/buying-medicines/generic-medicine-brands

Questions you may be asked about brand and generic medicines

There are many questions about brand and generic medicines that customers may ask you.

The questions and answers provided below will assist you in answering some of the questions that

may arise. If there is a question that you are not able to answer, refer to your workplace supervisor

or a pharmacist.


NATV3 230316 Page 51 of 78

What is an original brand medicine?

The original brand medicine is the brand name which was given to the medicine when it was first

discovered and developed.

When a pharmaceutical company develops a new active ingredient it is granted a patent for many

years, during which no other company can manufacture and sell a medicine containing the same

active ingredient. This allows the original company to make money on their investment for

researching and developing the new medicine.

What is a generic medicine?

After the patent expires on a new medicine other companies are also allowed to produce the

medicine. These are referred to as generic medicines.

A generic medicine must have the same effect within the body as the brand name medicine.

It must:

Contain the same amount of the same active ingredient(s)

Have the same onset of action

Work in the same way

Stay in the body for the same amount of time

Meet the same standards and rulings set by the Therapeutic Goods Administration (TGA).

Are there any differences in the quality of their ingredients?

No, there is no difference in the quality and quantity of the active ingredients of the medicine.

However the inactive ingredients such as the fillers, bindings, colours and coatings may be

different

If they are the same, why do they sometimes look or taste different?

Sometimes trademark laws do not allow the generic medicine to look or taste exactly like the

originator brand, so there is a difference in colour, shape, size or flavour. Some manufacturers use

different fillers, binders, coatings, colours and tablet markings when they produce the medicine.

However, the active ingredient(s) must be the same.

Why use a generic medicine?

Generic medicines may cost less, which provides better value for money. The use of generic

medicines also saves money for the Australian health care system.

Why are original brand medicines more expensive than generic medicines?

Original brand medicines may be more expensive to allow the company which made the medicines

to recover research and development costs and to profit from this discovery.

Companies that produce generic medicines often have lower business costs, such as research and

marketing, than companies that produce original brand medicines.


NATV3 230316 Page 52 of 78

How much can I save?

Generic medicines are around $2 to $3 less expensive per medicine. If you consider a few dollars

difference on several medicines over the course of a year, the savings can be quite large. For

example, a customer who is taking medicines for managing diabetes, blood pressure, cholesterol

and reflux could be saving more than $200 per year.

How do doctors feel about generic medicines?

Most doctors are happy for the customer to choose the brand of medicine they wish to take.

If, for some reason, the doctor wants the customer to take a specific brand, they will make this

known to the pharmacist by ticking the “Brand substitution not permitted” box.

When can a pharmacy provide a customer with a generic medicine?

The pharmacy is able to provide generic medicines under the Pharmaceutical Benefits Scheme if:

The patient agrees

The brands are marked in the list of medicines of the PBS Schedule of Benefits as able to be

changed

The prescriber has not marked the “Brand substitution not permitted” box

If it is allowed under State or Territory legislation

The Brand Premium cannot be used to count towards the PBS Safety

Net threshold

Advising the pharmacist

Once the customer has made a decision regarding the brand of medicine that they prefer, this

information should be passed to the pharmacist. This is often done by completing a prescription

check slip or stamping the prescription. You should follow your pharmacy’s guidelines for indicating

your customer’s decision to your pharmacist.


NATV3 230316 Page 53 of 78

Read your pharmacy’s policies and procedures. How do you pass on information

about your customer’s decision regarding generic or brand name medicines to your

pharmacist? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Other prescription premiums or surcharges

Note: In some situations a medicine may attract other premiums or surcharges which are

determined by government pricing policies, including:

Therapeutic Group Premiums, and

Special Patient Contributions.

These premiums apply to fewer medicines than Brand Price Premiums, and the way that they

apply can be a little technical. The information below gives an explanation of these premiums,

however for more specific information you should ask a pharmacist or follow the links provided to

the PBS website.

Therapeutic Group Premiums

The Pharmaceutical Benefits Scheme groups medicines according to the effect they have within

the body. A group of medicines that has similar effects in the body and similar safety and health

outcomes is called a “therapeutic group”.

The PBS subsidises all medicines within a therapeutic group at the level of the lowest priced

medicine. The difference in price between the lowest priced medicine and higher priced

medicines within the group is called a Therapeutic Group Premium. This is paid by the patient

and goes to the manufacturer, not to the pharmacy or the government.

There is always at least one medicine within each therapeutic group of drugs that does not have

the Therapeutic Group Premium. Medicine substitution by pharmacists within a therapeutic

group is not permitted. Medicines within a therapeutic group can only be substituted by the

doctor.

For more information visit: www.pbs.gov.au/browse/group-premium


NATV3 230316 Page 54 of 78

9. Check prescription waiting time and inform the customer

The process of dispensing a prescription can take some time. The time

taken can depend on:

The complexity of the prescription.

Whether a medicine requires special compounding, or is required to be ordered from a

wholesaler or supplier.

How busy the pharmacy is and how many other prescriptions are waiting.

The number of pharmacists and dispensary assistants who are working.

Other professional requirements such as the need for pharmacists to consult with customers,

speak with doctors, or provide other professional services.

Customers may wish to receive an estimate of how long the prescription will take to dispense. This

will allow them to decide whether to wait in the pharmacy while the prescription is dispensed; or to

leave the pharmacy to complete other shopping or jobs, or even to return home and collect the

prescription later.

Some pharmacies encourage customers to wait in the pharmacy, hoping that the customer will

browse the shelves and purchase other items while waiting.

Other pharmacies encourage the customer to leave the pharmacy and return later. This reduces

congestion in the pharmacy, and reduces pressure on pharmacists to rush the dispensing process.

Many customers are happy to drop off their prescription, do some other shopping, and then to

return later.

Special Patient Contribution

For certain expensive medicines where the government and the manufacturer cannot agree on

the price the government will pay to the manufacturer; the government makes a part

contribution towards the manufacturer's price. In these instances the patient pays their normal

co-payment plus a Special Patient Contribution. This is the difference between the

government's part contribution and the actual cost of the supplied medicine.

The Special Patient Contribution is payable by all patients in addition to the relevant patient

contribution for concessional and general patients. The Special Patient Contribution does not

count towards the PBS Safety Net.

For more information visit: www.pbs.gov.au/browse/special-premium


NATV3 230316 Page 55 of 78

Does your pharmacy encourage customers to wait in the pharmacy while

prescriptions are dispensed? Or does it encourage customers to return at a later

time? Describe below your pharmacy’s preference for customers waiting for

prescriptions.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Actions you should take:

Show the prescription to a dispensary assistant or pharmacist and check with them the expected

dispensing time.

Provide the customer with a realistic estimate of how long the prescription will take to dispense. If

you are too optimistic (i.e. “it will only be five minutes”) the customer will be frustrated if the

prescription takes much longer than that.

It is helpful to indicated to pharmacists whether the customer is waiting in the pharmacy or calling

back later. And if the customer is returning later you should indicate what time they will return. This

can be done by writing on a prescription check-slip or by attaching a “waiting” card to the

prescription using a paperclip.

How do you indicate to our pharmacists whether a customer is waiting or returning

later for a prescription? Describe your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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Reviewing the steps of accepting prescription

There may be a number of other things that your pharmacy requires you to check or complete

before passing the prescription to the pharmacist.

Speak to your pharmacist or Workplace Supervisor. List below any other

requirements that your pharmacist or pharmacy procedures require you to check or

complete before passing the prescription to the pharmacist.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Check: Who is the prescription for?

Check: Customer's name and

address

Check: Customer's history and

medical details

Check: Prescription date and

validity

Check: Medicare or DVA number

Check: Entitlement and/or Safety

Net number

Check: Items required by customer

Check: Preferred brand

Check: Waiting time


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What if something is not right?

Sometimes you may encounter a difficulty when accepting a prescription. There may be times

when accepting a prescription that:

You are unsure about the information on the prescription.

The prescription is incomplete or expired.

You find that the information on the prescription is difficult to read.

You suspect that a prescription has been stolen or forged.

If you receive a prescription where you feel concerned about the information or the prescription

itself, it is best to get help from a pharmacist, dispensary assistant or a senior pharmacy assistant.

A more experienced pharmacy staff member may be able to check the prescription and clarify any

problems; or they may confirm your concerns and assist you in solving the problem with the

customer or calling the pharmacist.

If you find yourself such situations do not blame the customer or the doctor. Problems with

prescriptions can have several causes and may be due to the doctor, the customer, another

pharmacy or even your own pharmacy. For example:

A customer may present a prescription without realising it is out of date, or has been fully

dispensed

A doctor may forget to write a customer’s full address on a prescription.

A pharmacist may attach the wrong repeat authorisation form to a prescription.

In the case of suspected prescription forgery, it is it is the responsibility of the pharmacist to decide

whether a prescription is suspicious and to contact the doctor and police.

No matter what the situation, the customer’s right to privacy and confidentiality must be

maintained. Any information that needs to be passed onto the pharmacist needs to be done quietly

and any questioning of the customer should be done in a private location.

Speak to your pharmacist or workplace supervisor. What are some common errors

or problems that are found on prescriptions presented in your pharmacy? List these

below

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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Passing the prescription and relevant information to the pharmacist

Submitting the prescription for dispensing

Once the prescription has been checked, information has been completed and the customer has

been questioned, all of the information needs to be passed onto the pharmacist. The completed

prescription and information that you pass to the pharmacist is important as it makes sure that the

customer receives the medicine they require.

Most pharmacies:

Have a position or location where the prescriptions are placed for collection by the pharmacist

or dispensary assistant.

Have a system for making sure that prescriptions are completed in the correct order.

Once a prescription has been accepted and details checked, where do you place

the prescription for dispensing? How do you ensure that the prescriptions are

completed in the correct order? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Transferring information to the pharmacist or dispensary assistant

Pharmacies use a number of different systems and tools to pass on information from the customer

to the pharmacist or dispensary assistant.

Some pharmacies use a prescription checklist or slip that is fixed to the prescription. This

checklist or slip allows you to provide the pharmacist with all of the information he/she will

need to complete the prescription. An example of a prescription checklist or slip is provided

below.

Some pharmacies use stamps that are placed on the prescription and allow the pharmacy

assistant to complete the relevant details and provide the pharmacist with the required

information.

Other pharmacies may transfer the information verbally. So that when the prescription is

handed to the pharmacist or dispensary assistant, the pharmacy assistant simply passes on

the information they have received from the customer. E.g. “Customer has a new address”,

“customer would like a receipt please”, “this medicine is new for the customer”.

In some pharmacies, information that is collected or checked, such as customer name and

address details, is entered into the dispensing computer at the “prescriptions-in” counter by a

pharmacy assistant.


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Prescription check-slips

Yourtown Pharmacy Prescription Check

Given name

Family name

Address

Date of birth (if child) / / New customer?

Medicare number _ _ _ _ _ _ _ _ _ _ ( _ )

Expiry date

Concession, pension or health care card

Expiry date

PBS Safety Net card

Pharmacy preferred brand? Yes No

All items? OR Number of items ________

Waiting? OR Returning at ________ am/pm on __________

Allergies or adverse reactions

Other instructions

Prescription check-slips such as this allow you to ask the customer all of the relevant information

and provide the pharmacist with the information necessary. This checklist is also a good tool to

help pharmacy assistants to remember the information that needs to be checked on the

prescription and all of the questions that need to be asked of the customer.

If the information that you provide to your pharmacist or dispensary assistant is not clear or is

incomplete a range of errors could occur. These errors may simply mean a delay for the customer

or it may mean that the customer receives the incorrect medicine. This could have serious results.

There will be times when you should pass on other information to the pharmacist or dispensary

assistant. For example, if your customer is unwell or in pain, it would be considerate to let your

pharmacist know. They may be able to process the prescription immediately and make sure that

your customer does not need to wait any longer than necessary.


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You may also receive prescriptions from customers who do not have a good understanding of

English. By passing this information to your pharmacist, they may be able to provide your customer

with information in their first language, or take extra time explaining the dosage requirements, or

provide printed information in the customer’s preferred language. By passing this information onto

your pharmacist you are ensuring that your customers receive the best possible care and

information.

Passing on simple information such as this will ensure that your pharmacist is aware of factors that

could affect your customers. This information will also assist both you and your pharmacist to

provide a high level of service to your customers.

What other customer information could be useful to the pharmacist? Write your

answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Be aware of your customers

Once the customer has been informed of the expected waiting time they will choose a course of

action. They may take a seat, browse in the pharmacy or leave the pharmacy to return at a later

time. Whatever the case it is important that you are aware of your customers and their actions.

If the customer is coming back to the pharmacy at a later time to pick up their medicine it may

be wise to make a note of this time and let the pharmacist or dispensary assistant know. This

information will allow the pharmacist or dispensary assistant to arrange their prescriptions in

order. It may also be useful to make a note of the time of their return and a few minutes before

they are due to arrive check that the prescription is ready for them.

If a customer chooses to look around in the pharmacy, or take a seat in the waiting area, it is

important that you are aware of the amount of time they have been waiting for the prescription.

If the customer has waited for some time it would be helpful to ask their name and check on

the progress of the prescription.

If the prescription is not yet completed, advise the customer of the time and advise the pharmacist

that the customer has been waiting for some time. Do not allow the customer to wait and wait

without letting them know the progress of their prescription. Many customers will be happy if they

are just kept informed. A customer who is ignored or not informed may become angry. Being

aware of your customer’s actions will make sure that you can check the progress of their

prescription.


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When things get busy

Pharmacies can be busy places with customers coming and going, phones ringing, and staff

members taking scheduled meal breaks. At busy times it is just as important to carefully follow your

pharmacy’s procedures to ensure:

The correct details are obtained so that pharmacists can dispense the prescription without

having to check information.

Your customer receives the correct medicines, and that any part of the prescription is not left

behind in the pharmacy.

Prescription forms are not lost and customer privacy is maintained.

Customers who are waiting for prescriptions are not overlooked.

You will learn what to do in busy situations like lunchtimes or after-school rushes with experience

and practice. It requires good communication and confidence in working with fellow pharmacy

team members. You may like to check with your pharmacist whether there is anything that you can

do to assist. If there is not then you may be best to remain at the prescriptions in/out customer,

accepting prescriptions and returning dispensed medicines as they are presented to you.

Above all smile and be friendly to customers as you serve them. They will see that the pharmacy is

busy and the people are working as best they can to dispense prescriptions as quickly as safety

allows.

Speak to your pharmacist or workplace supervisor. Are they any special

requirements that they have of you in serving customers when the pharmacy gets

really busy? List any such requirements below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Prescriptions by telephone

Sometimes you will receive a telephone call requesting that prescription is prepared. These can be

tricky to deal with. Here are some guidelines:

Doctors calling to authorise a prescription

Pharmacy assistants cannot accept a prescription from a doctor over the telephone; this also

applies to dispensary assistants. You will need to explain this to the doctor and then pass the call

to a pharmacist.


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Customers calling to request a new prescription

Sometimes a customer will call stating either that they have been prescribed new medicine from a

doctor, or they would like a repeat prescription dispensed (when they have the prescription in their

possession). They may wish to have the prescription ready for when they arrive in the pharmacy,

thinking that it will save time.

In order to safely and professionally dispense a prescription the pharmacist must have a copy of

the prescription in front of them. Even if the prescription is typewritten and appears clear to read

there are many factors that the pharmacist looks at to consider with a prescription is safe for a

customer to use.

You should politely explain that the pharmacist is required to see the prescription before they

dispense the medicine, and that they when the customer brings the prescription to the pharmacy it

will be dispensed as soon as possible.

If the customer requires further clarification, pass the phone call onto a pharmacist.

Customers calling to request a repeat prescription held on file:

A customer who keeps their prescriptions of file at the pharmacy may call asking for a prescription

to be prepared and ready for when they come in to the pharmacy. It is fine for pharmacy assistants

to accept such requests, retrieve the prescriptions from the file and lodge the prescription for

dispensing. Remember to complete a prescription check-slip or any other similar requirements and

to provide the pharmacist with any other important information, such as whether the customer will

be calling in to the pharmacy, or requires a home delivery.

See also the following section: Prescriptions held on file at the pharmacy.

Prescriptions held on file at the pharmacy

Most pharmacies keep a file for some of their customers who prefer to keep their prescriptions at

the pharmacy. In some states or territories it is a legal requirement that repeat prescriptions for

some medicines (such as Controlled Drugs) are retained at the pharmacy.

Each pharmacy’s procedure for retrieving prescriptions from this file may be different.

In some pharmacies prescriptions are stored in the dispensary; in other pharmacies they are

stored at the Prescriptions in/out counter.

In some pharmacies a trained pharmacy assistant can retrieve prescriptions from the file; in

other pharmacies only pharmacists or dispensary assistants may access this file.

When obtaining prescriptions from the file, and when returning prescriptions to the file it is

important that prescriptions from one customer are not mixed up with those of another customer. If

prescriptions are mixed up it may be difficult or impossible to find a prescription for a customer; and

it may lead to a breach of privacy.


NATV3 230316 Page 63 of 78

Does your pharmacy keep a file for customers who wish to keep their prescriptions at

the pharmacy? Where is it located? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

What rules does your pharmacy have about dispensary assistants accessing this file

to obtain a prescription for a customer? What rules does your pharmacy have for

filing dispensed prescriptions away for customers? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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NATV3 230316 Page 64 of 78

Returning dispensed medicines to customers


What happens to prescriptions after they are dispensed?

Ensuring the correct customer receives the correct medicines

Passing on information to the customer from the pharmacist

Confirming the customer’s understanding

Additional information that may be needed

Meeting customer’s needs with companion products

Packing dispensed medicines

“Your prescription is ready”

The time that it takes to dispense a prescription can vary considerably. This will depend on the

number of items requested by a customer, the complexity of obtaining and preparing the

prescription items, how many pharmacists and dispensary assistants are working, and how busy

the pharmacy is.

Dispensed items are usually assembled in baskets, tubs or another similar container. This allows

all of the customer’s prescription medicines to be kept together, along with: prescriptions that need

to be signed, repeat forms, CMIs, Self Care fact cards, receipts, PBS Safety Net documentation

and other items.

Once a pharmacist has dispensed and checked a customer’s prescription(s) they may:

Call the customer to the prescriptions in/out counter and speak directly with the customer.

Advise you that the item is ready to be handed out, and hand the items to you.

Place the assembled basket or container in a special area to wait for the customer’s return.

Describe below how and where dispensed medicines are stored in your

pharmacy’s dispensary.

What containers does your pharmacy use for assembling dispensed

medicines?

Where are dispensed medicines stored prior to collection?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


NATV3 230316 Page 65 of 78

If a pharmacist is speaking directly with a customer do not listen-in or stand too close; allow the

conversation to be conducted in privacy. However you should be ready to assist the pharmacist

and the customer by obtaining additional items the pharmacist might recommend, and taking over

the transaction from the pharmacist when indicated.

Be aware of customers who are waiting for prescriptions

When working at the prescriptions in/out counter part of your responsibility is to be aware of

customers who are waiting to collect prescriptions, and to watch for prescriptions that have been

dispensed and checked. If you notice that a customer is waiting for a prescription, or has returned

to collect their medicines, check on the progress of their prescription with a pharmacist or

pharmacy assistant.

The prescription may be ready and waiting for collection,

The prescription may be close to completion and you may be able to reassure the customer

that it will not be much longer, or

There may be an unexpected delay, or the pharmacist may require additional information from

the customer before proceeding.

Some pharmacies place small coloured cards in prescription baskets to

indicate to pharmacists that the customer is waiting in the pharmacy. This

alerts the pharmacist to look out for a waiting customer, or to hand the

prescription to a pharmacy assistant once it has been dispensed and

checked.

As soon as the dispensed medicines are ready, and the pharmacist has provided any necessary

information to the customer you should move on the next step of returning dispensed medicines to

the customer.

The process of returning dispensed medicines to a customer

This section takes you through the process including

Ensuring that the correct customer receives the correct medicines

Ensuring that you provide all of the required medicines and items to a customer

Correct customer – correct medicines

It is most important that the correct medicines are supplied to the correct customer; however there

are right and wrong ways to go about this process. With practice and experience you will find an

approach and set of words that you can confidently use to confirm a customer’s identity.

First let’s consider the following situations.

Waiting


NATV3 230316 Page 66 of 78

The pharmacist hands you a basket of medicines and you stand at the scripts in/out

counter and loudly announce:

“Mrs Annette Peterson! Prescription for Peterson is ready!”

This approach is not acceptable as it breaks the privacy of the customer. Mrs Peterson may not

want anybody to know who she is, or that she is collecting a prescription. By calling out her

surname in a loud voice other customers may now be watching to see who she is, and what

medicines she is collecting.

“Prescription number 724 is ready”

Some pharmacies which use prescription check-slips, have a tear-off piece at the bottom of the

check-slip. You might be tempted to call the customer to the scripts in/out counter using this

number, but in most cases:

The customer will not be aware that the check-slip has a number, and

The customer would prefer you to use their name, they do not wish to be treated like a

number.

“Tell me your address please”

Once the customer has been called to the prescription counter and you have their dispensed

medicines with you, you should make a further check to confirm you have the correct customer.

The customer’s address is one piece of information you can check, but always be polite about the

way you ask, for example: “To check that I am giving you the correct medicines, could I please ask,

what is your home address?”

“Is your address 52 Highland Way?”

If you ask the customer to simply confirm their address there is a risk that the customer will simply

say “yes”, even if this is not his or her address. They may be in a rush to leave the pharmacy and

go somewhere else; or they may have a poor understanding of English; or their medical condition

may be causing confusion, tiredness or deafness. It is always preferred that you politely ask the

customer to tell you their home address.

A better approach

You are aware that there are two or three customers waiting. You walk over to a customer

and ask them quietly:

Excuse me, could I ask whose prescription are waiting for?

This will allow you to check the finished prescriptions, and then call the customer to you by saying:

I think I have your prescription here now. Would you like to come to the counter?

Could I please check your home address?


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Before the medicines can be given to the customer and the sale processed, there

are a number of checks that need to be made. The next few pages discusse the

information you will usually be required to check.

This process may differ from pharmacy to pharmacy so it is important that you

check your pharmacy’s procedure, ask your pharmacist manager or workplace

supervisor, and understand what is expected of you in your pharmacy.

Name and address

It is important to check and confirm the customer's name (given name and surname) and their

home address. It is also wise to check that the customer’s name on the medicine match the name

and address on the prescription. This check will ensure that the medicines have been labelled

correctly and that the dispensed medicines were placed in the correct basket or container by the

pharmacist.

Collection by someone else

There will be times when a customer's medicines are collected by a family member or friend. This

may happen if the customer is ill, elderly or unable to come to the pharmacy, or for a parent

collecting a child’s prescription.

In these situations, you pharmacy’s policy may be to check and confirm both the customer and

person who is collecting the medicine. Your pharmacy may require:

Written permission from the customer allowing a family member or friend to collect the

medicine.

You to make a quick phone call to check that this person is authorised to collect the medicine.

You to ask for identification to check the identity of the person collecting the medicine.

You to make an additional check with the pharmacist before handing over the dispensed

medicines.

When signing for collection of the dispensed medicines the customer collecting the medicines is

required to sign and date the prescription and also to print their address in the section at the

bottom of the prescription labelled Agent's Address.

Your pharmacy may have a policy about collection of dispensed medicines by young people. For

instance, if the dispensed medicine is being collected by a person you consider to be under the

age of 16 or 18 you may need to check with a pharmacist to see if this is suitable in this situation.

Your pharmacy may also have special rules (policies) about what can and cannot be discussed

with the customer’s agent, and how the medicines should be packaged.


NATV3 230316 Page 68 of 78

It is necessary to balance the need for customer privacy and the need to provide the family

member or friend with clear instructions for the customer about how to use the medicine - when

another person is involved sometimes information is confused or forgotten. Possible approaches

include:

The pharmacist provides written information about the best use of the medicine; and you draw

the agent’s attention to this being included in the package of medicines.

The pharmacist speaks to the agent (family member or friend) who is collecting the medicines.

The pharmacist contacts the customer by telephone to speak with them directly.

You should let your pharmacist know when a medicine is being collected by a person who is not

the customer. By letting your pharmacist know about the situation you are allowing them to choose

the best method of passing on important information.

What procedure do you follow in your pharmacy when an agent (family member,

neighbour or friend) is collecting dispensed medicine for a customer? Describe the

process below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Check all medicines are present

We have noted that in most pharmacies medicines are assembled in baskets or containers with

copies of the prescriptions, repeat forms, receipts, and medicines information. However this can

present a challenge when handing medicines to a customer due to:

Some dispensed medicines are too big to fit into the standard pharmacy baskets.

Some medicines require refrigeration and have been placed in the medicines refrigerator.

Some medicines require additional security and have been placed in the Controlled Drug safe.

A medicine may be out of stock, or the pharmacist may not be able to provide the full quantity

to the customer that day.

A medicine may accidentally have fallen into or from another customer’s basket.

A customer may be frustrated to return home to find that they have not received all the medicine

they expected; this may even interrupt their medical treatment. However if a customers’ medicine

is provided to the wrong person this is very serious. Firstly the customer’s privacy has been

broken, but more seriously there is a risk that the wrong medicine may be swallowed by a

customer.


NATV3 230316 Page 69 of 78

You should also check that all the items on the prescription have been supplied.

There will be times when a customer requires all the medicines on the

prescription and there will be times when they may only want one or two. Before

supplying the medicines to the customer, you should check the prescription

against all the medicines that are present. This check will ensure that the

customer is not forced to return to the pharmacy again to pick up any medicines

that were missing.

Some prescription medicines are temperature sensitive and will need to be stored in the pharmacy

refrigerator until the customer comes to collect their medicine. By checking that all required

medicines are present, you may identify that some medicines are stored in the refrigerator and let

your pharmacist or dispensary assistant know. Your pharmacy may have a specific procedure to

follow for refrigerator items, such as the use of tags or labels to identify this.

What system does your pharmacy have for alerting pharmacy assistants that a

prescription is incomplete, or that dispensed medicines are stored in another

location? Describe the system below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Check all documents

You will need to check that the right documents are present. The prescription needs to be with the

medicines so that the customer can sign and date it. You may also need to check for repeat

prescriptions and make sure that they are given to the customer or stored by the pharmacy. You

may also find that your pharmacist has included some other information to help your customer’s

with their medicines. This information provides advice and information that will help them achieve

and maintain good health.

At this stage, most pharmacists will also want to do a final check of the medicines before they go to

the customer. Your pharmacist will check the medicines and check the quantities, dose and labels

to make sure that the customer is receiving the correct medicines and the correct information.

What checks need to be carried out in your pharmacy before the prescription

medicines can be supplied to customers? What is the pharmacist responsible for

checking? What are you responsible for checking? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


NATV3 230316 Page 70 of 78

The pharmacist will speak to the customer and provide them with information

about their medicine or their condition. This allows the customer to ask questions

about their condition or the medicine they are taking. Customers may also talk

about their concerns or identify other symptoms they have. This step is critical and

will allow the pharmacist to provide your customer with expert information, advice

and care.

Provide additional information

Your pharmacy may require you to provide additional material and information to your customer.

Information or material Description

Repeat prescriptions Repeat prescriptions may be short term or on-going. You need to:

Check the name of the customer matches the repeat prescription

that you are giving them

Remind the customer to have the repeat prescription processed

before the current prescription runs out

Place the prescription in a safe place so that they do not lose it.

Some pharmacies hand repeat prescriptions to the customer,

which may be preferred as customers may throw out

prescriptions if they are placed in the paper bag.

Advise the customer to

read the label carefully

Check the label on the medicine and ensure the correct customer

name is on the label. Advise the customer to read the instructions on

the label carefully and to take the right dose. This may include

helping with information about cautionary and advisory labels that

may also be on the medicine.

Consumer Medicines

Information (CMI)

Consumer Medicine Information (CMI) leaflets provide customers

with additional written information about Prescription Only Medicines

and Pharmacist Only Medicines. CMIs include important facts for the

customer to know before, during and after taking their medicines.

Medicines lists A Medicines List helps the customer to remember information

about all the medicines they are taking. The customer can carry the

list with them all the time. This list usually contains:

The name and strength of the medicine

What the medicine is for

How much the customer needs to use and how often

When the customer started using the medicine

When the customer should stop using the medicine or talk to

their doctor or pharmacist about the medicine/s they are using.

The customer and/or the pharmacist and/or the doctor can fill in the

details required. Medicines lists can be printed from the National

Prescribing Service’s website; they can also be produced by some

pharmacy computer systems.


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Information or material Description

Remembering medicines If a customer tells you that they are having difficulty remembering

medicines you could suggest the pharmacy places their medicines

in a dose administration container, which can filled weekly at the

pharmacy. If a customer has missed taking a medicine, refer the

customer to the pharmacist.

Reliable internet

information

Examples of trusted health information sites to which you can direct

the customer include:

www.healthinsite.gov.au the Australian Government’s Health

website.

www.betterhealth.vic.gov.au/ the Victorian Government’s health

information website.

www.healthinfonet.ecu.edu.au/ an Australian indigenous health

information website – excellent for Aboriginal and Torres Strait

Islander customers

www.nps.org.au the National Prescribing Service for providing

quality use of medicines information and resources.

Make sure to check with your pharmacist before providing any of the

above information to your customers

Signing for receipt of prescriptions

Once the pharmacist has spoken to the customer, you should complete the process of returning

dispensed medicines.

Firstly the prescription form needs to be signed and dated by the customer. This signature is used

to confirm that the customer has received the medicines. The prescription is then kept by the

pharmacy and used in claim from Medicare Australia under the PBS. If the prescription is not

signed, it is not valid for claiming, the Medicare Australia will not accept it and the claim may not be

paid.

There will be times when a customer is unable to sign for a prescription. Examples include

customers with injuries, such as a broken hand, poor vision, or customers affected by medical

conditions such as dementia or confusion, and times when prescriptions are sent by post or

courier. In such situations a pharmacist can sign the prescription to certify the medicine has been

supplied. Return such prescriptions to the pharmacist and explain why the customer was unable to

sign. The pharmacist should then certify the prescription and include it in the PBS claim.

Storing signed prescriptions securely

Once the prescriptions have been dispensed and signed it is important that they are stored in a

secure location. These prescriptions are required as part of the PBS claim and may be worth

hundreds of dollars to the pharmacy. They also contain a customer's personal details and

information regarding their health and medicines. Completed prescriptions should be treated with

great care and stored in a safe and secure place.


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Once a prescription has been completed and signed where, in your pharmacy,

should it be placed? Write your answer below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Relaying information to the customer

There may be times when the pharmacist asks you to relay simple information to the customer,

family member or friend. This task should always be completed under the direct supervision of the

pharmacist.

The information that you have to pass on to the customer may include:

Dosage,

How to use the medicine or

Storage details.

Your pharmacist may also ask you to repeat information that is written on the pharmacy label or on

the cautionary/advisory labels on the medicine.

Speak to your pharmacist or workplace supervisor. What are some examples of the

information that you may be asked to pass on to customers? List them below.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


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If your pharmacist asks you to pass on information to your customer, it is important that you take

great care. The information that you are passing onto your customer will have a direct impact on

their health. If you pass on incorrect information, or incomplete information, your customers may

not take their medicine in the correct way. This may have very serious consequences.

When your pharmacist provides you with information to pass onto the customer, you should

listen carefully to the message. Take note of the words that your pharmacist is using and make

sure that you listen to all of the instructions. If you have any questions or are not sure about

the information that your pharmacist has given, you should take the time to ask questions and

check the information.

By asking questions you are checking your understanding and making sure the information

that you pass on is correct.

By repeating the information back to your pharmacist, you are also checking the information

and allowing your pharmacist to check that you understand the information correctly.

Once you have a clear understanding of the information or instructions that your pharmacist has

given you, it is important that you pass this to your customer.

Do not provide your own judgement or instructions on medicines or health

conditions.

Do not include extra information or leave out information that you feel is

irrelevant or useless.

Do repeat the information or instructions exactly as you heard them.

There may be times when you may want to add extra information or

instructions. You may have heard your pharmacist give this information to this

customer or other customers at other times. You may feel that your pharmacist

is busy and has forgotten to give you this information and you are just trying to

help.

It is important that you do not add further information or provide advice. The

information should be repeated exactly as the pharmacist gave it to you.

Confirm the customer’s understanding

Once you have passed on the information or instructions from your pharmacist, it is important that

you check the customer has a clear understanding of this message. We often think that the

customer has understood the information. We need to stop at this stage and check that the

customer has understood the message.

Customers may nod their head, smile and agree with us without really understanding the

information we have given them. They may do this for a number of reasons:

A customer may not wish to appear stupid and will pretend to understand.

A customer may not have a good understanding of English.

You may have a customer with hearing problems who did not hear the information clearly.

A customer may not wish to be a bother and take up your time or the time of your pharmacist.


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Use a range of methods to check that the customer has understood the message.

If a customer has a question or concern

There will be times when providing dispensed medicines to your customers that your pharmacist

will need to be involved. For example:

A customer may seem not to be sure of the medicine or feel concerned in some way.

They may ask questions about their health condition or the medicine they are taking.

A customer may have forgotten to ask the doctor a question or have noticed a change in their

medical condition.

The customer may be taking other medicines or may be travelling to another country.

The customer may describe that they are experiencing unwanted effects when taking a

medicine.

Speak to your pharmacist or workplace supervisor. What are some other examples

of situations when a pharmacist should become involved in a conversation with a

customer? List three (3) examples below

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Ask questions

Questions will help you check that the customer has understood the

information and may reveal other concerns or questions that they may

have.

Simple questions such as “Do you understand when to take this

medicine?” or “Do you have any questions?” can let customers know that

you care about their health.

If a customer has a question or concern, you should then refer them to

your pharmacist

The customer may provide you with non-verbal information that shows us

they do not understand what you have said. A worried or a confused look

may mean that you have to ask the pharmacist to speak to the customer.

Sometimes a customer may simply nod or smile when we pass on

information. It would be best to check if they understand by asking

questions.

Look for non-

verbal signs


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No matter the reason, it is critical that all questions relating to prescription

medicines or further requests for information must be referred to your

pharmacist.

Your pharmacist is the only person who can answer questions or provide

customers with further information on prescription medicines. If a customer

asks a question or needs further information, they must be referred to your

pharmacist.

Pharmacists have undergone many years of training. They have a thorough understanding of

medicines and how they work in the body. This training enables them to listen to customer's

concerns or questions and provide them with the information or advice they need. Pharmacists are

also able to ask specific questions and find out essential information about a customer's health or

medical condition. And finally, pharmacists have been trained to identify possible problems or

warning signs.

You are not trained to do this and no matter how many times you hear a customer's question or

your pharmacist's response, you cannot provide this information to customers. If you were to

provide further information and advice to customers, you may not pick up essential information

about the customer's health or you may provide information that is incorrect and quite possibly

dangerous.

Your role is to work with both your customer and your pharmacist to ensure that each person has

the opportunity to ask questions or find out more information. You can communicate information

clearly from your customer to your pharmacist and let them know about any concerns and issues.

You can also reassure your customer that the pharmacist is happy to see them and feels it is

important to speak to them about their medicine or health condition.

When you provide customers with their medicines, they are likely to ask

your opinion or advice about their treatment or medication.

Customers will often do this because you are the person who they deal

with when they come into the pharmacy and they feel comfortable talking

to you.

Customers may ask you questions because they think the issue is minor

and they don't wish to disturb the pharmacist. A customer may ask you a

question because they see the pharmacist is busy and don't want to wait

until he/she is free.


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The Pharmacist The Pharmacy Assistant

Is an important source of expert

advice

Assesses the customer’s health

and needs

Provides medicines and health

care advice

Assesses whether a customer is

using a medicine correctly.

Considers whether a medicine is

working as expected.

Refers customers to a doctor

where appropriate.

Records and follows up advice

as required.

Is an important link between the

pharmacist and the customer.

Provides general product

knowledge and advice to the

customer.

Refers customers with

symptoms, medical conditions or

queries about medicines to the

pharmacist.

Ensuring that your customer has everything they need

When customers come to your pharmacy they expect to be provided with a complete service which

meets all of their needs. A customer may get upset if they get home and find that they don’t have

all of the products they need to take their medicines or improve their health.

An important part of your role when providing prescription medicines to your customers is to make

sure that they have all of the products that they need to take their medicine and achieve good

health. This is not an opportunity to force customers into buying products that they do not need.

Rather, it is an opportunity to make sure that customers have all the tools, equipment or products

they need. Your suggestions may save the customer returning to the pharmacy later in the day to

purchase items they need.

There is a range of products that you can suggest or recommend to your customers when you

provide them with their prescription medicine. The following is some of the items you should

consider:


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It is, however, important that your pharmacist is aware of any items that you suggest as companion

products. There may be times when a companion product should not be recommended. Your

pharmacist is the person who is able to judge this.

Speak to your pharmacist or workplace supervisor. What are some other examples of

companion products that can be suggested to customers when they come to pick up

their prescription medicines? List them below

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Prescription items

Medicine measures

Soap substitutes

Analgesics

Electrolyte replacement

Spacer devices

Ice packs

Wound dressings


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Packing dispensed medicines

The process of supplying prescription medicines to customers also includes wrapping and

packaging those items. With all items sold in the pharmacy, care should be taken to make sure that

items are wrapped and packed carefully so that they can be transported safely. There are a

number of simple steps that you can take to ensure that prescription medicines remain safe and

secure.

Prescription medicines should be wrapped or packed separately from general pharmacy items.

This is a safety precaution and also they can be easily identified by the customer.

Prescription medicines should be packaged in a bag or packaging that makes sure that the

medicine cannot be seen by others. Some prescription medicines may cause embarrassment

to customers. Careful packaging of these medicines will make sure that these medicines are

kept private.

Prescription items that are temperature or light sensitive should be placed in insulated

packaging with cold packs. Speak to your pharmacist or the dispensary assistant to ensure

that you are following correct procedures, and be sure to keep some fridge blocks frozen for

this purpose.

Always remind the customer of temperature or light sensitive items and of the special storage

requirements. This may include instructions to refrigerate as soon as possible, and offering to

hold the item(s) in the pharmacy refrigerator till a more convenient time if this is not possible.

Some products are packed in glass bottles or containers which may be heavy or have an

additional risk of breakage. Consider carefully how you will package these containers to

minimise the chance of breakage.

Conclusion

The processes involved in accepting a prescription from a customer and returning dispensed

medicines are important. By carefully following pharmacy procedures you will help to ensure:

The pharmacist has all the information they need to dispense a prescription.

The customer received any subsidies, or price concessions they are entitled to.

The correct customer receives the correct medicines.

The customer knows how to use the medicine correctly and how to store their medicines.

Prescription forms are not lost or misplaced

Customer privacy is maintained.

Customers are offered other pharmacy items they require to use their medicines or treat their

medical conditions.

During the first few weeks that you work in the pharmacy you may find these processes confusing.

There may be times when you are unsure and confused. Remember, your pharmacist, your

workplace supervisor and other pharmacy staff members will be able to help you.

Ask questions, learn the process and know what to do. This will help you will make sure that your

pharmacist receives the right information and the customer receives the right medicine.

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